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APPLICATI�1 FOR CONSTRUC�'ON PERMIT� <br />CITY Of EVERETT • BUILDING DIVISION <br />3200 CEDAR STREET • EVERETT, WA 98201 • 259-BB10 <br />❑ DEMOLITION D COMBINATION ❑ BUILDING �MECMANICAL ❑ PLUMBING ❑ SI6N <br />PROJECTADDRESS: . . � i , _ / . . _ __ _ _ <br />'1�� � <br />1[W�N� uulMMi[55 G1Y Iiv 1'�b1E <br />•1CJM1IfC1MOCSIGN[(1 Y111.�U�11F55 Cln' l�� R�F <br />RU4BNGCp1�P61q1 4utl.Oq�E55 QfY l�V ��qNF SIAIEI�CENSE• <br />e,� -�� n ���� c � ��,,�,� �_ <br />nrqrouo us[ a auia�o <br />im�i ocxwrrwn or rnw�cnn �aawr+enow rn�n.cr� two ca+cs <br />tot eioc. a <br />7 �� —l-C��- c=(l .�_ �1ZCZ <br />w+cu r�.a � o mr+acn p <br />��t� I'0�)�0'DOti'U�. <br />LpI51MILfICN lOullCNpE�1. �OMESS. iEl[AqNE MMRF11 <br />PLUMBING <br />NO. TYPE OF fl%TUP[ O{i 1TEY <br />� TOTAI FEE S � _ <br />FOR OFFICE USE ONLY: <br />fPONiAfiP�CR �lt11[fIBILN SIOESFtB�d <br />USEIONC lO1�OG V6/.HIyIE <br />❑YES ❑ NO <br />uncn uurtenox ra as uwuuxc s�xe or eia:n� <br />' -- I ' ❑vF5 ❑ MO <br />finEsrmNxicna[oo nf�mv <br />CITY OF EVENETT <br />LOCALSALES <br />TAX GODE IS �105 <br />HEATING SYSTEM: � GAS O ELECTRIC ❑ <br />cor�t�crrcnsa.,�.orwncrro . <br />I HEflEBY CERTIFY TNAT I HAVE REAO ANO EX�MINED TNIS <br />APPLICATION AND NNOW TNE SAME TO DE TRUE �ND CORRECT �LL <br />PROVISIONS OF LAWS A`!D ORDINANCES GOVERNING THIS TVPE OF <br />WORK WILL OE COMPLIEU WITN WIIETHER SPEGIFI[0 HEREIN OR <br />NOT. THE 6RANTING OF A PEPMIT DOES NOT PRESIIME TO GIVE <br />AUTHORITY TO VIOLATE OR CANCEL TME PROVISION OF ANV <br />OTHER STA1E OR LOCAL LAW REGUUTING CONSTRl/CTION OR iHE <br />PERFORMr1NCE OF CONSTRUCTION. THAT I AM RUTHORIZED BY THE <br />OWNER OF THIS PFQPERiY i0 PERFORM THE WOP0. FOR WHICH <br />APPLICATION I$/MAD � y I COMPLV WITH THE STATE <br />CONTRACTOR AW . 7 RGW ND 29fi200 WAC. <br />/ � /� 7 <br />z o+rt <br />SIGM�IM[ <br />G�Y &19NLSS lCCNSC NO <br />n�ec�rcawiunrn r�r <br />FEES <br />P1nl0�vf. <br />n�mm�m <br />MfC11�NIC/�1 <br />•OplroN�l iY�N61fCM <br />oiu[n <br />surz nunon+n sunou�rc:[ <br />raputmin.s __ <br />TOTAL <br />nrcrmtra <br />