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APPLICATIO� FOR CONSTRUCT�N PERMIT//��� <br />CIN OF EVERETT • BUILDING DIVISION �/ <br />3200 CEDAR STREET • EVERETT, WA 98201 •(425) 257-8810 <br />f� OEMOLITION �COM8INATION O BUILDING ❑ MECHANICAL ❑ PLUMBING ❑ SI�N <br />✓ <br />PROJECTADDRESS:g$Oq__ZIK Dr S� <br />r.irr <br />n <br />r,tMnucoHm�c�rn u��uoon[ss oiv nr ruo�o .�nivair>c. <br />4FC���41CI�<(JyI�1A�I0�1 4I'1�11b��<5 flh . P110Nf SI�fFI�CENiE� <br />P111401NGC01111!�f.lpi N�II.A�IGf1E�5 LIiY IIC FMO'IF SI�IFIICEN5F1 <br />ca+tn.n nmcE o� wo��n <br />HFATING SYSTEM: �GAS ❑ ELECTRIC ❑ <br />�rscnmv vmax �wo saueur r��ucs w��v[o can�t� > �Sov+Mo cdtw,r riu <br />� <br />Ilo� SS BIOLx <br />1 �nPCCII�YIII <br />DRINKI�G F <br />FLOOR DPP <br />DACKFLOW <br />S� a' <br />��5,�� ���—�. I NEREBY CERTIFY 7HAT I HAVE READ AND EXAMINED THIS <br />APC�ICATION AND KNOW THE SAME TO BE TRUE ANO CORRELT A�L <br />PROVISIONS OF UWS AND OADINANCES GOVEFNING THIS TYPE OF <br />WONK WILL BE COMPIIED'NITH WHETH'R SPECIFIED NEREIN OH <br />:mwp�.neo�rnoconcs NOT. TME GRANTING OF A VERA+.IT DOES 7!OT PFESUME TO GIVE <br />or AUTMORITY TO VIOLATE OR CANCEL THE PROVISION OF pNY <br />OTHER STATc OR 1.00A� LAW REGUUTING CONSTRUCTION OR THE <br />7ERFOPMANCE O^ CONSTRUCTION. TNAT I AM AUTHOPIZED BY THE <br />OWNER OF THIS L'ROPERTV TO PFRFORM THE WORK FOR WHICH <br />APPLICAiION IS MAOE AND I CCMPLY WITH TME STATE <br />CONTFACTORS LAY: I8 2] qCW AND 296200 WAC. <br />:�wEriuuRFn x' AL��(�/(�'�, IZIIOl47 _ <br />5 e 4 uae wrz <br />Ci1T OUSNE55lCENSC NO <br />SUBTOTAL S <br />FOR OFFICE USE ONLY: <br />IntM�4lnux nren5rtp¢r <br />uxrnrv imente <br />11f1(i1��IIVIIAII()4 �10 p I�WCIIIMG <br />I. �1:: <br />a:car�vcr . cca�n�e��wn <br />�am7 <br />:l ' li'/ I ._—_—_ <br />� mc nwm em�o <br />/ 1 <br />J <br />s�ocsne�c. ruuuaanuunrn <br />� -I ( <br />v�Uv� srz FEES <br />❑Y[5 ❑ NU q��11��, <br />i11E Of 0{q' 1 %/f <br />�� ���L MIIYPVO <br />R�SryFMI yffe�4iC�1 <br />❑\[S Y�J _— — <br />�UpI10N�1 i`Il4 CII((:K <br />murn <br />[1111 fli1.lU'�Nf.511nf,llnfl :f <br />CITYOFEVERETT ruancwnn�vc <br />LOCALSALES <br />TAX CODE IS 7705 TOT�L <br />FEE <br />TOTAL S <br />mrFlr� r�o <br />'__"GC�_� 00 <br />'v�ov <br />