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APPLICATI� FOR CONSTRUCT�N PERMIT <br />CITY OF EVERETT • BUILDING DIVISION � <br />3200 CEDAR STAEET • EVERETT, WA 98201 •(425) 257-BB10 <br />❑ DEMOLITION ❑ COM8INATION y� ❑� BUILDI,N/�f: ❑ MECHANICAL [ ❑ PLUMISNKi ❑ 8NiN <br />PROJECTADQRESS:�3v(J I�Y��.�� I rcU QI UV �C�'L rI l� `Gr;i�, i <br />sD% �c��. �i-�h�✓i S�_ir��t .,c�- 9�ss .._...�izo�� va n� <br />f.FMENICOY�n6�0i1 4u1�IXx�[Ss C�h I�r nxrvr <I�q�KfMsf. <br />7.nfp G�L o (,' Z1 '-1 <br />MFO��bGlCfW11UC�041 4Ml�fM�ESi LIM1 I.P pp4f 54fflKiNSf� <br />PIb.�BMGCONIN�f.�M M�itRIfMF55 CI6 I�� ��f SIMFIK[NS!• <br />io� eiocR _ <br />n.ncn uv i o rmwtn <br />corsimic�w.�io.MirurFn.u�n�css. <br />FOR OFflCE USE ONLY: <br />1�ONIYiP�CR O[�p� <br />IltflOYf Illl�P <br />W 6u� 1��I1���04 <br />occw�.�r.r u�n.r.nes <br />f.11p�• <br />fIR[ $VpIIMIFR PL�j'D <br />IIqF /.IAPM P1 O D <br />NO lv pwf IONG I SIlF O� <br />1i4i6 <br />HEATING SYSTEM: ❑ GAS ❑ ELECTR�C ❑ <br />Cb11�L1 MnSpN �MI r�vyl{ ryp <br />I HEHEBY CERTIFY THAT � M�yE READ �ND E1fAMINEO TMIS <br />APPUCATION AND NNOY/ TME SMIE TO BE T17UE �ND LORRECT ��� <br />PROVISIONS OF LAWS �ND ORDINANC[S GOVEPNING THIS TYPE OF <br />WORI( WII1, BE COMPLIED WI1H NMETNER SPECIFIEO HEREIN OR <br />NOT. iHE GRANTING OF � PERMIT DOES NOT PRESVME TO 61VE <br />AUTHORITY TO VIOLATE OR C�NCEL THE PROVISION OF ANY <br />OiHER S7ATE OR LOCQ �AW REGULATINQ CONSTRUGTION OR THE <br />PEHFORM�NCE OF CONSTRUCTION THAT I �M AUTHOR2ED BY TIIE <br />OWNER Of TNIS PROPERTY TO PERFORM THE WOF1( FON WHICM <br />RPPLILATION IS MADE AND I COMPLY WITH TNE ST�TE <br />CONTRACTORS l W 1027 RCW �ND 296 200 W�C <br />��%�J��/ � �-y—�%I <br />s�eima o�n <br />CIIY IIVLM[S liC[NS[ NO <br />A�l�CR R�N[I�l[n�NyV41UP <br />�w� 9rt pEEf <br />OYES O n0 . P11�� <br />O�fS pr0 <br />CrtY OF EVERETT <br />LOCALSALES <br />TAX CODE IS �105 <br />rvuunmr, <br />4i11144y'�1 — <br />•pplNnq h �N 6xf� <br />OtN[n <br />cl�ll MVi14m::51111C1��11(:! <br />nmur. �ns <br />TOTAL <br />nttnm rq <br />