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APPLICATI�1 FOR CONSTRUC�ON PERINIT� <br />CITY OF EVERETT • BUILDING DIVISION <br />3200 CEDAR STREET • EVEFETT, WA 98201 • 257-8810 <br />ANICAL ❑ PLUMBING �"1 SIGN <br />❑ DEMOLITION <br />aROJECT ADDRESS <br />❑ COMBINATION ❑ BUILDING <br />2qs� h� �� <br />M�IL�fIM. E5$ CItY <br />❑ MECH <br />ilf/ � 9��/ <br />���y jp qp��[ SiI.fELqExSF• <br />f.ENCM t 1C10�1 N�lAppRE55 <br />MCO4MPlCONIP610� ���II.DWIC55 CiIV SiP INON[ S1�1ElKRRE� <br />ttUM�'�NGCONIIIAGi011 M�RApJRE55 LI1Y 2iP PllplC Sl�ll.LICUISC• <br />lJf BLOCY <br />r�Acu r� �i o H�UM%ecn <br />��-f � <br />CONS1nUC1pNWN1lEfNEf <br />HEATING SYSTEM: ❑ GAS rl ELECTRIC ❑ <br />coHr•c* rcnsw� u�o r.wr+e xo <br />>.�r <br />I MEREBV CERiIFY THAT I HAVE READ AND E%AMINED TMIS <br />APPLICATION AND KNOW THE SAME TO OE TPUE AND CORRECL ALL <br />PROVISIONS OF LA\YS AND ORDINANCES GOVEFNING 7HIS NPE OF <br />WORK WILL �E COMPLIED WITM WMETHER SPECIf1ED MEREIN OR <br />ivwwrioc�oww�neo�TMo�o���s� NOT THE GRANTING OF A PERMIT DOES NOT PHESUME TO GIVE <br />_or AUTHORITY TO VIOLATE OR CANCEL TNE PROVISION OF ANY <br />OTHER STATE OR LOCAL lAW REGULATING CONSTRUCTION OR THE <br />PERFORMANCE OF CONSTRUCTION. THAT I AM AUTHOR2ED BY THE <br />OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WMICH <br />APPLICATION IS A1ADE AND I COAIPLV WITM THE STATE <br />CONT TORS LAW 18.27 RCW AND 296200 WAC. <br />� - 1 - /�/// <br />PCSi.iCIFMqNENJNBEH X 1LLa��� ;//Z� <br />s�cnuunc • oem <br />CIiY pO5wC55liCCHSf.'q _ <br />OISP <br />GAS <br />FAN <br />FOR OFFICE USE ONLY: <br />.nnut[eix¢x PC�RSE104P 5'��CS[iB�CR flANCNCLRMIwBLa <br />USC40M1E IOi�PG <br />MEICIIIIIlAl1�1qN 110IrOf OJiCLL11Mi <br />INUNi5�1E _ <br />❑YCS ❑ NO gpilCCki <br />pi plpGT I <br />PIUMBING <br />15LNCNf MCp1AHC1L <br />❑YFS ❑ NO <br />AppIfICN�LPlANC11CC�1 <br />omcn <br />sr�tE ounomc suAo�u+ce <br />CITY OF EVERETT ruai�c wonns <br />LOCAISALES <br />TA% CODE IS 7105 707AL <br />