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APPLICATI� FOR CONSTRUC�N PERMIT� <br />CITY OF EVERETT • BUILDING DIVISION <br />3200 CEDAR STREET • EVERETT, WA 98201 • 257-8810 <br />n oEYO�rt1oN '�. COMBINATION f� BUILDING ❑ MECMANICAL ❑ PLUMBING ❑!WN <br />SG^'I <br />•NC111LEG1pnCC5K'iMP 4�il�ppiC55 Ciiv IiP �'I��E <br />�tV401NGLON1P�Llq1 �'.��I��DM55 C�ir 2iF R�TC $1�iElY.EMSE• <br />wr eix• _ <br />H9S5'-aiy - <br />FOR OFFICE USE ONLY: <br />i�o�irs(i6�cK nElesEtl <br />-, . - <br />ase:rnrt .�,, io�u+c� <br />Iq IX <br />/ 11N115 <br />s�u[s[�eacx <br />. . � �_, <br />NEATING SYSTEM; f7 GAS ❑ ELECTRIC <br />cori�.c* �casov �rw r1qrv[ ra <br />lt� �'C�=�1�� �� � � �D`i� —7�V� <br />I HE BY ERTIF AT I HAVE REA� AND E%AIAINEO THIS <br />APPLI ATI ANO K W THE SRME TO BE TRUE AND CARRECT. ALL <br />PROVISIONS OF UWS AND ORDINRNCES GOVERNINO THIS TVPE OF <br />WORN WIIL �E COMPLIED WITM WHETHER SPECIFIEO MEREIN OR <br />NOT THE GRANTIYG OF A PERMIT DOES NOT PRESUME Tb GIVE <br />AUTHORRV TO VIOLATE OR CANCEI THE PROVISION OF ANY <br />OTMER STRiE OR LOGAL UW REGUUTING CONSTRUCTIOP� OR THE <br />PERFORMRNCE OF CONSTRUCTION. TH�T I AM AUTMORIZED BY iHE <br />OWNER OF THIS PROPEFTY TO PERFORM TNE WORN FOR N711CH <br />RPPULRTION IS MqDE AND I COMPLV WI7H THE STATE <br />COHTRAGTORS LAW 1gRt11FW AND 296.�00 W�C. <br />t�a- I /5 4 � v <br />n•�s �� ou�m�� <br />SIIE Uf BlWil <br />�,.�i S F ��VufliM: - <br />B�5[ (NI �� M(CN�NC4 <br />�I$ �Np <br />�ooitxM4R�XCM[CR <br />OLNER <br />SiAi[ BULLMNG SIINCnNG[ <br />I CITY OF EVERETi rua�r. won.s <br />LOCALSALES <br />TA% CODE IS 3105 ioT�L <br />a[cnorw <br />