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APPLICATI� FOR CONST6iUCT�N PERMIT <br />CIN OF EVERETT • BUILDI�G DIVISION � <br />3200 CEDAR STREET • EVERETT, WA 98201 •(425) 257-8810 <br />❑ OEMOLITION ❑ COMBINAT�N �, BUILDING ❑ MECHANICAL � PlUM81NG ❑ SIGN <br />PROJECTAD�RE55: Z�OX '1{� t)R, W— �-✓��f'�`� � <br />V.Pu�, �'Fkefs�l, �N1c �RtOt <br />O'M�FII 4ML/.f.'C1�f55 PiY LO� PMMC <br />eAti. �ff° ' o � <br />rtx�v� vui �nonEss nrv i v <br />�TAr� S�Ql,E�h� 10"� ����-,. "° S . ,.'SIUREcn!cr�;i,� 4kIS) -546-03ti <br />•��xRctonM4nWrtn uui�IXmF55 <br />�A/uLK — <br />GfNE�A�COH1111C�C�1 N�IIAp[N1f55 C�1� li=_ f�ll!)4[ �1�1L1=C(NSF� <br />!✓ouE ' — <br />uco��M�cucr,rm.r.ran om�oa'Fss nrv m� r��aar s�•�ru<[�+s[� <br />����..e�..,,sl`'....—�7���U_-._- - � �� <br />cw+mect �n¢� ar wnnK . � � i A II <br />C[$CPIPf WJ�1N AMf) SOJ�nf {OO��GE �IVp' <br />(4�ffni��,lhtt�'c 6J� � <br />�RhPF l�iirH �SI <br />��1�� - <br />MroroSf o ust or nmmiNr. <br />l�E D"l DGe <br />tf W l �6Cn0'nPi O� Pnq`EniV/�IS��q�WN BL <br />�o� �� IuocK �YY-- <br />1I � <br />�VL✓TH W � <br />7 <_ h2C7 �' 1 <br />{O/N <br />BATHTUB <br />FOR OFFICE USE ONLY: <br />rnOM�ulMrn nf�P1 <br />1151- l� J I 1 O11i <br />I�FtC11�11V11/y1iO4 '01'O� <br />a <br />CCl11C�4':V L�!'Ci��l'91i (J('CVI <br />i[1[ � E <br />HEATING SYSTEM: ❑ GAS <br />r.om.ct vrnsoH •.m n.ovr r�o <br />�J <br />I HERE�Y CERTIFY iMAT I Mr1VE REAp AND EXAMINED THIS <br />qPP�ICATION ANO KNOW THE SAME 70 BE TRUE ANO COHRECT ALL <br />PROVISIONS OF 1�W5 AND OR�INANCES GOVERNING THIS TYPE OF <br />� WORK WIIL BE COMPLIED WITH WNETHER SPEQFIED HEREIN OR <br />Dm[si NOT. 7NE GRANTING Of A PERAIIT DOES NOT PFESUME TO GIVE <br />GS }� AUTHORITY TO VIOLATE OR CANCEL THE PROVISION OF ANY <br />OTHER STATE OR LOCAL LAW RF.GULATING CONSTPUCTION OR THE <br />PERFORlAANCE OP CONSTRULTION. TMAT I AM AUTHORIZED BY THE <br />OWNER OF THIS PqOPERiY TO PERFORM TME WORN FOR WHICM <br />APPLICATION IS MADE ANO � COMPIY WITN TlIE STATE <br />CONTRPG70R$ lAW 1B 2] RCW ANO 296200 W/C <br />,�, � 7�Q��. . L-I (- 99 <br />�•cnerone w�r <br />f.itrBo9�rcS5lrcMsf vo <br />SUBTOTAL S � <br />PERMIT 5 <br />70TAlFEE 5 <br />90C SF�B4a <br />/ <br />�i- V�L}�IISIIC <br />�� OYfS ❑ IA1 <br />ll�l <br />NG Silf W BLW�� <br />� � <br />�O B6F4fN� �� <br />❑t[5 lS'+O <br />AIP <br />pinlM4f. <br />I�IIVP.tifi ... <br />VFI M4YH:♦ <br />�pq�1(14�1 I'IINC��lC <br />U���fP <br />c�nll flu�l��'�f.SunCn�nLF <br />nrtor�<i nnvs��raov�oe• CRVOFEVEflETT n��r.wn�uc <br />LOCALSALES r — <br />��/� ����� 7AX CODE IS J105 To711L <br />UNITS <br />(WOOD <br />�p nFfer� nn <br />3�� ' �— <br />.. VAWOTI011 FEE r_ <br />I� . � '— <br />----- _�- <br />I �_ � <br />