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APP'LICATIQ� FOH CON�TRUC7'�N PERMIT� <br />CITY OF EV _RETT • BUILDING DIVISION <br />3200 CEDAR STFE'cT • EVERETT, WA 98?O7 • 257-8810 <br />❑ DEMOLITiON ❑ CG;".BINATION LI BUILDING ❑ MECHANICAL ❑ PLUMBING ❑ SIGN <br />a v:�PROJECT ADDRESS �Q/D(p g � �yp � <br />ueiieooicss , cim zw vrwr+e <br />AAfI�_�y,�L.Lz%BQLEd' � ��E EI/EKE7% 9P�r� y�5 •3�9-8968 <br />�u�r uu�Aooncss <br />7 �l <br />! 1i ' �C <br />pR01'OSEOUS[OFOUIL�Iw1 ' <br />61NC>.���2 <br />LEf0.�E5LBIPlILNOFPPOPLPiY151WWNBELOW PALiACH <br />ior _p2�— a�a� _ cF�LfGI <br />Ajlj�Sinal *' � <br />vnneei -rx i o �muoen <br />�?iri,_'�= 000 ' 6 �17 ' B� <br />CO45T9UC�p/'��ORN N�'F. NEjS.1ElE� �E�N��EA, <br />/•�QL�� R7� IV L�ICYiL <br />IE1�J.l11 <br />/_ 7N. � <br />SUB <br />o�o <br />FOR OF�=10E USE ONLY: <br />iR�NiSEiOR:K �EARLEiORCN <br />UiLIONE LOiMEI <br />r�[IGNLLIIAIinild: UN�n��wELLINO <br />TYV[ OF CONSi <br />�— � <br />LIIY ur r....... <br />I-SSB-�9a- ;�/oo_ <br />GiY ilV PNIXiE SGIELICENSE� <br />n NEBINN +� 0 33 ��E _ <br />S <br />5 _ <br />smc scre�cx <br />VALI.NI $11E <br />❑VEi ❑ NO <br />)F BIOGR i <br />bsE i <br />❑Yci Y^V <br />HEATING SYSTEM: �GAS ❑ ELECTRIC ❑_ <br />:ONGGi PEP5011 NID FNONE Iq <br />DAUE P,AERC-�. N��•KnR-N379 -- <br />�On� �!,!. /� 48�• 5�3A0 <br />I HEREBY GERTIFY THAT I HAVE READ AND EXAMINED TMIS <br />APPLICATION PK�D KNOW THE �AME TO BE TRUE AND CORRECL ALL <br />PROVISIONS OF LAWS AND ORUINANCLS GOVERNING 7H1S TYPE OF <br />WOPK WILL BE COMPLIEO 1NITM WHETHER SPECIFIE� NEFEIN OR <br />NOT. THE GRANTING OF i. FERMIT �OES NOT PFlESUME TO GIVC <br />AUTHOR!TY TO VIOLATE OR CANCEL TM� PROVISION OF ANV <br />OTHER STATE 08 LOCAL LAW REGULATING CONS iNUCTION OR T4E <br />PERFORIdANCE OF COYSTRUCTION. THAT I Atd AUTHOPIZED BY TNE <br />OWNER OF TMIS PFOPCRiV TO PEFFORM TNE WORK FOR WHILH <br />pPPLICATION IS M AND I COMPLV WITH THE STATE <br />ON � RS IB 2 RCW AND 296.200 WAC. <br />� _�900_ �a •�3- �y <br />�. <br />WOOD STOVE <br />METAL FIREPL <br />GASRANGE <br />GAS PIPING <br />am¢rtm <br />nuuorzq <br />YECIUACµ <br />MOItiOnALPLW CNECK— <br />OMER <br />S1AiE I'U�LDiNG SUPCNMGE <br />I'l9LIC WOFFS <br />ITOTAL <br />'] O <br />