Laserfiche WebLink
�n. Ewry,Mn <br />�IF/ OF <br />everett <br />BUILDING DEPARTMENT <br />259-8745 <br />`;�PPLICATION f0� <br />CONSTRUCTION <br />PERMIT <br />TO BE COMPLETED IN INK- PLEASE PRINT <br />U DEMOLITION ❑ COMBINATION ❑ BUILDING ❑ MECHANICAL ❑ PLUMBING O SIGN <br />M�IUDORE59 GITv SiP ( VNONf <br />OWHER ` C� �ibl�� �.�J�C/Sy�' <br />1 • � C—' �-s �S',b��rr v � `� i, <br />/t •[� C T(�. cin. ziv o��ox[ <br />�qCNI1EGIUPOCSiONER MMl�0ORE99 <br />GINCIULG�NIfUGIOR M�IlA0DNE55 Cltt ZIP PI�ONC IIClbS'r • <br />MCCN�HIC�L CON�P�GIOq <br />MMI�DUNES9 GI/Y ZIP PHONC IICf��51 • <br />FW MBIN�J CON IPAC1011 <br />MML�ODBE99 CIIV IIP PI�ONE llClhti! . <br />O"NEWV ❑ ADDIiION ❑ ALiERATION ❑ REPAIR ❑ DEMOLITION <br />� n �t � 1 ���C� <br />DE9f.N��K <br />T • \� �1. � <br />iRAY <br />_ I Ill)tlf NInINs 11nINl FAf1FIlA.. _.... "_'_'_' <br />WOODSTOVE/FHPL.INSERT ❑ BUILOING AELOCA�ION <br />I HEREBY CERTIFY TNA1 I HAJE READ AND E\<��A�NED THIS AP• <br />PLICATION AND KNOW THE SAME TO BE TR'JF AP�LtiGUARECT. ALL <br />PHOVISIONSOF LAWSAND OHDINAMCES (.�.^,:.RNING THISiVPE <br />OF WORK WII.L BE COMPLEiE.D W�TH Y!' �c1Ntp SPECIFIED HERE <br />IN OR NOT. THE GRAN?ING OF P, ^�PMIi DOES NOT PPESUME TO <br />GIVE AUTHORITY TO VIOLAIE OR CANCEL THE PROVISIONS OF <br />ANYOiHER STATE OR LOCAL LAW REGULATING CONSTRUCTION <br />OR THE PERFOfiMANCE OF CONSTRUCTiON. <br />mnu�niacncCnNT1UCTONOR/.UTNOR�2EOAQENT O�iE <br />I�1 <br />cirv <br />M <br />METAL FlREPUCE 6 CHIMNEY__ _ <br />/7 <br />THIS PORTION TO BE COMPLETED BY BUILDING DEPT. PERSONNEL <br />�nOn�5Et0�CK 11GRSEIBACM <br />91pE?EiB�tlt �L�NStlEGNNUMBEII VUNCr�ECKrtE <br />FEE I AFLEIPI NO <br />U5: <br />CpN4i <br />910A�E9 <br />BY <br />V�G�Nf 511E <br />❑YE9 ONO <br />fOA <br />BUILDINO <br />PLUMBINO <br />MELIIANIL�L <br />OTNEiI <br />PEN�ITY <br />TOTAL <br />iEEb V1LU�TION � sE[ <br />f <br />