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APPLICATION FOR CONSTRUCTION PERMIT � <br />TO BE C�PLETED IN BLACK INK—PLEASE PRI1� <br />`I ;:a-`lh � <br />HEATING V <br />BUILDINO DEPARTMENT S STEM. � GAS U ELECTRIC U <br />259•8810 <br />❑ DEMOUTION O COMBINATION !_7 BUILDIN(3 '�IIECHANICAL ❑ PLUMBINO � SION <br />_l_����\�v� 1��� E��13 �14�'" ��,i- ��,� =�P J�- �i�ao3 ��s- ly�i9 <br />nwvrt �,u��oonees cm :iv vrane <br />� W4 <br />1 i011 WIL <br />I�CT011 �Ull <br />� <br />f W011lf <br />O� <br />AND 80UARE FppT110! <br />LEML OflCRlVflp� p plqpl <br />LUT lIOCN <br />r�ncn r� i.o. Nuwee9 <br />LAUNDRY <br />ROOF <br />81NK 1 <br />'0 <br />ADd1E88. TE1E7110NE <br />i� <br />8 DISP <br />FOR OFFICE USE ONLY: <br />PRONftEL�ACN REARBET <br />UfE SONE lOT MEA <br />IYIE p CpqT. M0. OR 6T <br />tREOflIW. fIREBPRM <br />pAIE <br />CIiY TIP <br />CITY z�p <br />GONT�p7 PEPSpN �ND PIIONE NO <br />LICENBf 1 <br />LiCENBE 1 <br />1 HEREBV CERTIFV THAT I HAVE REAO AND E%AMINED THIS <br />APPLICATION AND KNOW THE SAME TO BE TRUE AND COHRECT. ALL <br />PqOVISIONS OF LAWS AND OROINANCES OOVERNINO THIS TVPE OF <br />n'+o��e� WORK WILL BE COMPLETEO WITH WHETHER SPECIFIEO HERG:� OR <br />NOT. THE aRANTINO OF A PERMIT DOES NOT PRESUME TO 61VE <br />AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANV <br />OTHER STATE OR LOCAL lAW REODUTINO CONSTRUCTION OR THE <br />-- PERFORMANCE OF CONSTRUCTION. THAT I AM AUTHORIZED BV THE <br />OWNER OF THIS PROPERTV TO PERFORM THE WORK FOR WHICH <br />APPLICATION IS MADE AND I COMPLY WITH THE STATE <br />CONTRACTOPS LAW 18.27 RCW AND 2D8.700 WAC. <br />x_��1R�i-Cikl �Qa�ilon.�1L� !T/��`�3 <br />sonuw� rt <br />V�C�NT BiTE <br />r! Y@S `. = N� <br />ottw.xn +oaovnu�urnt <br />aaw <br />❑ ves ❑ No <br />CITY OF EVERETT <br />LOCAL SALES <br />TAl( CODE IS 3105 <br />UNIT HEATERS—BS.U. M <br />CLOTHES DRVERS <br />FIREPLACE INSERT <br />HEATPUMP <br />GAS PIPING <br />VLAN CNECN NUMBEp <br />BUiI�ING <br />PLUMBINQ <br />MECMRNICAL <br />ADDITIONAL PUN CHECN <br />OTHER <br />BTATE BUILDIN6 SURCHAROE <br />PUBLIC WORNS <br />TOLAL <br />FEE I RECEIiTNp. <br />