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APPLICATI� FOR CONSTRUC7�N PERMIT� <br />CITY OF EVERETT • BUIL�ING DIVISION <br />3200 CEDAR STREEI • EVENETT, WA 98201 • 257-8810 <br />fl I:EMOLITION '! COMBINATION [�BUILDING ❑ MECHANICAL C7 PLUMBING ❑ SIGN <br />�wn�. ��.�i.o�n��ss ci.. � ��N � irwxc <br />i'f.n�Flt�t�i�cks 40�7 R�uLhCf A r r rrFf1 �.� y�ro3 30L �fi51 � 3a9y_— <br />tENnNi 1Aail�WPL55 fitY ]9 A�pr,[ <br />!�r � ��� � yH th Avn L�.n'+�a�:� 9RJ'f � N� �? 7 5-�� •�� <br />nnCl� CCIOl�DCSGNIP Y�IL�OIX1[Si C1iY 1�' MJM1[ <br />1-i.�n /Na:t�.� .'+7� Tni.o�yp a✓t. TaCO�.rO 98HO�1 <br />rt. n4cwneq*au u�iuopYss ntr in pup¢ sul[lqcNs[. <br />�a:tn� R•✓r: ca, �Z_Ta•:on,a q✓e raGoma 9bvo� ar� s4G-� ar or�nG�N <br />ucour�e.�coxraec*on uu✓,ronrs urv :v nror�c surtir[us[. <br />�wuoe..:cann.cton uuuo�[;s cuv nn nrorrc —••rz�ku�sn —' <br />canncn en�et a ��rn�. <br />HEATING SYSTEM: fl GAS I� ELECTqIC S? <br />C011i�CIt.LR50M�NDP11pNClq <br />�i0- l�Onrl .Y <br />I HEREDY CERTIFV TNAT I MAVE READ AND E%AMINEO THIS <br />APPUCATION AND NNOW TNE SAME TO BE TRUE AND WRRECT ALl <br />rv����sm osc or em�o��Aa PROVISIONS OF LAWS AND OR�INANGES GOVERNING TMIS TVPE OF <br />/�0��9f �✓� "+F. G�1CCk �o�l,;no S ? WORK WILL GE GOMPUED WITN WHEiHEP SPEGIFIED HEREIP OR <br />imuascnmtpuor raoa[nrv�sanimnowon�n•cN cu�¢s� NOT TME GRANTING OF A PERMIT DOES NOT PRESUME ID GIVE <br />�o� e�aK w AUTHOPITY TO VIOLATE OR CRNCEI THE PROVISION OF ANv <br />OTHEfl STATE OR LOCAL LAW REGULAiING GONFTRUCTION OR iME <br />PERFORMFNCE OF CONSTRUCTION. THAT I RM qUT110R2ED BY THE <br />OWNER OP THIS PPOPERTY TO PERFORM THE WORK FOP WHICN <br />APPLICATION IS MADE AND I COMPLY WITH THE STATE <br />r.r„¢ u. io r.0 ocn CONTFACTORS LAYI t0.17 RCW A D 256200 WAC. <br />� a ia o�.� ao x��l�� <br />CO�i51RVLlION L041lFNDFN. �CIX1C55 1[lll`Mp�l( �NUOCN <br />S�GN��Uf1E t[ <br />CiIY 6USM[55 JLlNS[ IW <br />ORINNING <br />FOR OFFICE USE ONLY: <br />rnc�isue.cx nunpowce sresoe.Cn n��+c��c+Houe r[E <br />- l: � S �aCr — (�d/n �- 0/�- <br />.6LIDbt.. � Il0lPnl� IYnGNiS'1 <br />f7 ^, YIS <br />rii,�nllllAll/161N 14'JClChLLtlr�: SilEC101Pi1^ <br />VNiIS .l � J <br />C1C5 JC: W <br />EVItCING <br />rmunauc <br />�ICCII�NC4 <br />/.Wi1qN4Pl�NCN[Cn <br />O� SV b '�� onrtn <br />..unuuwo nc.mLv �y ./ <br />In� yN4�) � �J�7�✓ Si�hBUR�!tKSUPCMAPGE <br />t a m�rsr�� V,�.� i�uns.r�-io ar CITY OF EVERETT �veic wwus <br />1�� � / LOCAL SALES <br />� r�=nL� �. O IG � TAX CODE IS 3105 TOT�L <br />