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APPLICATIO� FOR CONSTRUCT�N PERMIT <br />CITY OF EVERETT • BUILDING UIVISION � <br />3200 CEDAR STREET • EVERE7T, N'A BP201 • 25B�B810 <br />❑ DEMOLITION ❑ COMBINATION ❑ BUILDIN6 1i1 NECHANICAL O PLUMHIN6 ❑ SION <br />PROJECTADDRESS: Z�Q� M�aK��T�--�.� �° �-tp7n� <br />cv[NtcOM1nq1IX1 4�i1Mln[5s �-/�,f. I� I "�' _li�• " r�Uv[ 41FlKM5F� <br />In� I A'Ct:.✓1 �'�-,n cz 7 Qra� 'i�(`1�1�.�LYi_� 24L `��UU ���'Ly� � 3�e-� <br />�ECN�V�GlCdI1PeC1IX1 4ut�dNlESj tl !�P Nlplf Sq1EUCEN$(• <br />VWUBMGCONIP4;�p1 Yul�qM1�� C�Iv �--�tu� �� P�KK�F SiMElKfNSE� <br />ascnecwonv�vo, r,n¢roo�w vavco <br />�� L� � Rc <br />nnorosco usE a nuipw <br />IFG�tDFSCw>tiwW impYnrvlSibMNe[�ow <br />io. eioc+ or_ <br />� <br />r.ncs� rlu i o. ruuecn' I <br />y � �� ��i <br />CbJS�NUCTON lOAN l[NM11 1fIpIF55.1[IfAld <br />FOR OFFICE USE ONLY: <br />mcr�isnn�a nuncnn�cx <br />m�.nu <br />NEiG�RUMItI.tqN 4OfY0WCl4NG <br />UMII{ <br />n.�c <br />NEATING SYSTEM: � GAS ❑ ELECTRIC �J <br />---- — z�z-�( ���, <br />I HEf1E0Y CERTIFY THAT i MAVE READ ANO E%AMINEO THIS <br />APPLICAiION �NO NNOW THE SAME TO BE TPUE RJD CORRECT ALL <br />PROVISIONS OF LAWS AND OROINANCES GOVERNINC iHIS TYPE OF <br />WOI1K WILL BE COMPLIED WITH WHETNER SPECIFIEO HEREIN OH <br />NOT. i11E 6f1ANTINO OP A PERMIT DOES NOT PRESUME TO GIVE <br />AUTIIOI71tY TO YIOL�TE OR C�NCEL THE PROVISION OF nNY <br />OTHEI7 STRfE OR LOC�L LAW REGULATINO CONSTqUCTION uR THE <br />PERFOfiMANCE OF CONSTRIICilO . THAT I AM AUTMpRIZED BY THE <br />OYMEO OF THIS PR PE FORM TME WORK fOR WHICM <br />�PPLIL�TION 1 ND I COMP�V WITH TME ST�TE <br />CONTRACTO L 1 AN 2962001VAC. <br />x <br />SifN���MF 0� E <br />p�v1111LNFS5tC[v5C1q <br />MECIIIINICAI - <br />smEs[�e•a nwturtx�mm�rn rcf <br />wc•ntsn[ fEES <br />❑vf5 ❑ MO pinll�nif• <br />N BIDGrtI <br />1'IIN�IINfI <br />6�SEMEXf Y�fp�Mf.N <br />Ov[s ❑rm <br />•mxixmu nwcmcx <br />mm�i_' <br />SiMI Om�l�nx: tih�lf���l�(IE <br />CITVOFEVERETi rumr.wm�: <br />LOCAL SALES --- - -- — <br />TAX CODE IS J105 TOTAL <br />11ff.FM}Np <br />