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APPLICATIO� FOR CONSTRUCT�N PERMIT//��/� <br />CITY OF EVERETT • BUILDING DIVISION `/ <br />3200 CEDAR STREEf • EVERETT, WA 98201 •(425) 257•8810 <br />❑ DEMOLITION ❑ COMBINATION ❑ BUILDING �J MECHANICAL ❑ PLUMBIN6 ❑ SION <br />PROJECTADURESS: �2i1� d\ L S�. <br />�...1.�. S iti. 231i .x�L' Srl C� i8la I � <br />1[N�41 441AUMF55 GlY )IV V110NF <br />OI1ChAGqU� M��I <br />lin <br />GfNC11��LCON111�L1Cf1 N�II�WIiE55 LIIY !�� �•���JY[ �I�II.IICtna!• <br />4ib��NiPlfOYm�CtOP 4��l�WUF.55 L��'I ]m vu0.( [I�IFl4CH5E� <br />�.'�� •ir,. Sa.��l 5�... P: (Svr �rpS L'� '18706 1f1�31W FVC'xG5�Sl1ik�! <br />rWu^NccoNlNr,rpP Nn1��U1E55 Grr }�n v,q4F SI�IFI�CEMsfr <br />COrv10�L1 PItlC[ Of WOI1X <br />" 3 �l o HEA7ING SYSTEM: � GAS ❑ ELECTRIC ❑ <br />i <br />I HEREBY CERTIFV 7NAT I MAVE READ AND EXAMINED TMIS <br />rnqbsFo ust ar nunoiva APPLICATION AND RNOW THE SAME TO BE TRUE AN� CORRELT µ� <br />PROVISIONS OF UWS RND ORDINANCES GOVEFNING TNIS TYPE OF <br />��s��� P�r� WORN WILL BE COMPUED W�TN WHET/1ER SPECIFIEO HEREIN OR <br />ireuo[sr.uinnpiaarror[nrv�vqwr�etmrvon�ne�urvqcoAesi NOT. THE GRANTING OF A PERMIT DOE$ NOT PPESUME TO GIVE <br />�o� _ eiocn or AUTHORITV TO VIOLATE OR CANCEL THE PROVIS�ON OF ANY <br />07HER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE <br />aERFORMANCE OF CONSTRUCTION. THAi I AM AUTHORIZED BV THE <br />OWNER OF THIS PROPERTV TO PERFORM TNE WORK FOR WHICH <br />APPLICATION IS MADE AND I COMPLY WI�H TNE STATE <br />reniu uR i o Mnnnen CONTRnCTOPSIAW IB 2� qCW AND 296100 WAC. <br />LONS�f1UL1i(.WIO�NIfNtIFf1.MI1�CS5.lEl[1'NOYENU4pEN x � �C-ll.`�w� .Z'2�' �[i <br />_ SIGNI.IUB ��t[ <br />G1Y BU9NE55I�CFNS[ Np <br />FORCED AIH <br />LAVAiORY <br />$IHR <br />SUBTOIAL f <br />FOR OFFICE USE ONLV: <br />�nrrn¢RNfk nrenSflP�ra s�o[sEl94l r1euO�FC �i�F fft �KPmxo <br />m.�,-nur io�.rne v.cer��5r[ ��5 VALUATION I <br />❑Vf$ ❑NU RIMIfIIYf. <br />��hi'."+���wf��N� vOG�Uwflli� gIkO�Bla9� �----- — <br />�''I�:: 1`IIIMPWC <br />�� <br />1�1:1 :.pta:'ItEll� <br />(H:IIi�•�N11U�0 II�St4fN� N!('I��A�1'II � 7 <br />❑\Ei ❑N�l ___ __l_�._._ <br />��� ���� Apqll(1N�I 1'1 �N CII(fM <br />OU�Fii <br />n1�cqV — <br />Slul fl11YU�A1:50nb��npF <br />r�n.�vrmovrnnr CITVOFEVERETT ��iw���'wa�+s <br />LOCALSALES <br />�„�E TAX CODE IS 3105 TOT�L <br />