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APPLICATI� FOR CONSTRUC7�N PERMIT� <br />CITY OF EVERETT • BUILDING DIVISION <br />3200 CEDAR STREET • EVE(iETT, WA 98201 • 257-8810 <br />1-, DEMOLITION ;S COMBINATION ❑ BUILDING C7 MECHANICAL ❑ PLUMBING "i SIGN <br />owwcn um�ooptss cur zw rirorrt <br />_Susr 0.�.tc �,�y��„ct;u� �0 3oxao�i3 Euvert SA.�o3 �/ts�3a9'3/75 <br />1[NI.Nf 4A1t�00��[55 CRV $p �rypy� <br />��+CnRWrOncESGn[n uuleDpn�sS citr zu� puGryc <br />f.L1.lR4WNIPh^.1M unLLnCqvC55 Cilv l�n PI�JNC SG![lKMS[• <br />�4AS� Q'it funSirec��.�n QG. $M' .�043 tuueN 96203 'LtS�4,A3i7 i Sa TR *r 7Z�, <br />uce�uveucOrna�ccn u�iunoa[s; cirr rm M«mE setcien�sf. <br />�LVYLi1qCOH1111f.ip1 1A11��DJNL55 CItY IIV �IIJIIL $iAIEIKLNSE• <br />7 <br />�o+ <br />cor�smocuorv wui ¢rvocn +ooncss rntrrror¢ uv�A[n <br />yiars <br />FOR OFFICE USE ONLY: <br />If���!ll$CIp�O RCARCCt6 � 5'�OC[[IBA[N <br />�r <br />nc� e <br />�i�- a <br />„� :,,�,��, <br />r:'3%� <br />� ��:i .�n�m�i�n <br />wrnnu <br />n r�o <br />��o.o�T,,,.,:, s�r�aa,�:,, <br />ururs ��}�7� 5��� <br />oc.:uvun iow ws ucNE r � <br />I : tC5 aJ�J <br />HEATING SYSTEM: �1(i GAS ❑ ELECTRIC f— <br />�m��..0 i u�wnnrvon�a¢ im <br />P1F1it N75-.�nF <br />i MEREEiY CERTIFY THAT I HAVE RGAD AND E%AMINED TMIS <br />APPUCTTION FN� FNOW THE SAIdE TO �E TRUE AND CORRECT. PlL <br />PROVISIONS OP LAWS AND OROINANCES GOVERNING THIS TYPE OF <br />1YOPK WILL OE COIdPLIE� 1YITH WNETHER SPEQFIEU 11EREI•� OH <br />NOT iNE GRFNTING OF A PERMIT DOES NOT PRESUME TO GIVE <br />AUTNORITY TO VIOLATE OP CANCEL THE PROVISION OF ANY <br />OTMER STAiE OR LOCAL LAW REGUTATING CONSTRUCTION OR TNE <br />PERFORh1ANCL OF CONSTRUCTION. THAT I Ald AUTMURIZED �Y THE <br />OWNER OF THIS PROPERTV TO PERFORM TME WORK FOR WMICN <br />APPLICATION IS h1ADE ANO I COhIPIY WITH THE STATE <br />CONTRACTORSL 1Y1B2]RCWAND296200WAC. <br />x_.,��1�� 7-as-�� <br />64:N�IUR[ D�IC <br />Cilv 0115iN155 t�C[M1SL iiJ <br />��A� /�7-�""1�i7 11.�'� <br />PI�yU�Li�N-N-l�14�C[��� /'� f[E r p RCLEIPINO <br />�'�� �li0d.�� I <br />FEES VALUATION <br />a�:,�,�: 6 <br />rm�.�e�.�� <br />�IELI��NiC4 <br />I�WiIbN4FlANC1�CCR <br />Oi11lH <br />f In1E PUu�itG SUBLuePGE <br />CITV OF EVERETT ruouc �mnns <br />LOCALSALES <br />TA% CODE IS J105 To7AL <br />