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APPLICATI� FOR CONSTRUC�ON PERMIT <br />CITY OF EVERETT • BUILDING DIVISn � <br />3200 CEDAR STREET • EVERETT, WA 98201 •(42: ,-8010 <br />M ❑ COMB�NATION ❑ BUI OING ❑ MECHANICAL ❑ PLUMBING � SI6N <br />• � �� � �% <br />7RESS:1-.�.2��T i�-r�� y�,L- <br />C�\I CTT .A/� O�J59Ij� ' _ <br />E <br />... _..�.__.....� __.._._..� _ 98y9D _ _ <br />MfO4u�GlCOVImf,�O� 441�f[WF55 biY )u•— I•�A\f cuq1�CFN[[� <br />PIVMpnf.CU�i�Nf,�m 4��UQME55 f.11Y )IC �Hb�1 5����IKLNSf• <br />COMf11�[I Im�C! lN WIN�R <br />�---� MEATING SYSTEM: Cl GAS O ELECTRIC ❑ <br />BioCK <br />B/THTUB <br />•ancs� �[i • ^�wrE wwntn <br />I FOR OFFICE USE ONLY: <br />I oCi ro�r__ — <br />uf �fd�l I'wIM�U\ <br />I `��nl5n:.�-lfvPLTt1— <br />i�[ �IPPN PI r: p <br />PERMIT S <br />TOTALFEE S <br />w� u��. <br />•o a nw�ii�w <br />w�,r <br />o.�t_ <br />c <br />IB�Cn <br />I HEREBY CERTIFY 7HAT I MAVE RE4D ANO E%AMINED THIS <br />APP�ICATION ANO NNOW TME SAME 10 �E TRUE AND CORPECT ALL <br />PROVISIONS OF LAWS AND ORD'NANGES GOVERNING THIS TYPE O� <br />WORN W�IL BG COhIPLIED WITN WMETHER SPECIFlEU MEREIN OF <br />NOT. TI1E GNANTING OF q PERMIT DDES NOT PRESUME TO GNE <br />AUTHORITY TO VIOLAT[ OR CANCEI THE PROVIS�ON OF �NY <br />OTNER SiATE OR LOCAL UW REGUUTING CGNSiRUCTION OR THE <br />�ERFORMANCE O(' CONSTRUCTION TIIAT 1 �M AUTMOFIZED OY iME <br />OWNER OF THIS PROPERiV TO PERFOPM TM! WORK FpR WHICN <br />APPUCAT104 IS MADE 4ND I GOMPLY WITN TNE STATE <br />GO"lTRPCTORS lAW 1P 27 RCW AND 29fi 200 WAC <br />u <br />� <br />UNIi <br />ry �N fl�lf Y'NV Pf <br />❑rts n M n�.�rr«�. -- <br />eioc�i —__'--.' <br />m�mvn <br />eerwt� vr�n,�n�.i_ .. _—_._' <br />❑�[5 ❑ Y1 _.. <br />� yyMll(IV4 �1�V �.'�rtl� <br />� tlf��f� _ <br />�I�tl N�P.IIy\1:��111f��Ml.� <br />CITYOFEVERETT ���e.:.�.. .� <br />LOCAL 511LE5 - � - --- -- <br />TAX WUE IS J105 TOTl1t <br />SUO TOiPI <br />PEPMIT <br />tOTALiEE <br />�r <br />V�LUIITION <br />1---_' __ <br />� <br />� ___ _ <br />m �nnn�n <br />FEE <br />_�_.__—�__ — <br />" ' __'_{__— <br />