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N� Ewrpmn <br />an ov <br />everett <br />BUILDING DEPARTMENT <br />259•8745 <br />S�-_PPLICATION FO��{� <br />CONSTRUCTION <br />PERMIT <br />TO BE COMPLETED IN INK- PLEASE PRlNT <br />everetl <br />� <br />❑ DEMOLITION ❑ COMBINATION J� BUILDING ❑ MECHANICAL ❑ PLUMBING ❑ SIGN <br />MAIL�ODRE59 CifY 2�F PNONE <br />OWNER . . . . � i. i. .. _ ..._ _ —_ ' .. � _ <br />PNONE <br />OENERAIGONTR�CTOR M�IL�ODRE89 Clrv UP PHONE 4CENSE• <br />MECH�NICAIGONTPACTOfl MAR�OORE99 CITY 21P PHONE UCEIISE• <br />PLUMBIH]CONTR�GfOH M�IL�DDBE99 CIiY ZIP PIIONE LICENSE� <br />CL�990F WONN <br />❑ NEW � ADOITION ❑ ALiERAiION ❑ REPA1 ❑ DEMOLITION ❑ WOODSTOVE/FRPI.INSERT ❑ BUILDINO RELOCATION <br />VAW�TIONOiWONNIC09TOfM�1ENUL5PLU9L1180P1 /`'� <br />ADD/NG A r?fH/t D£Ck A fR/JNT �£CK Qua A BENCN TO Yac <br />DESCHIBE WORK <br />USE <br />��I <br />TYFE Of CONST. <br />8o/R f3�veaLy <br />EvE.re//. N.t2,�. <br />I HEREBY CERTIFI' THAT I HAVE fiEAD AND E%AMINED THIS AP- <br />PLICATION AND KNOW THE SAMETO BETRUEANDCORRECT. ALL <br />fOURGOPIES� PROVISIONSOFLAWSANDORDINANCESOOVERNINGTHISTYPE <br />OF WORK WILL BECOMPLETED WITH WHETHER SPECIFIED HERE• <br />IN OR NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO <br />�GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF <br />AlJV OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION <br />OR THE PERFORMANCE OF CONSTRUCTION. <br />SIONATUNEOFCONTRRC70AOflAUiHORIZEDACENT DRiE <br />Y ,�' /l�'c���;,�-.�s� �Ev% <br />�on�ic�uiAf.ITYBlI5MES9LIL 9EN0 <br />M <br />THIS PORTION TO BE COMPLETED BY BUILDING DEPT. PERSONNEL <br />�CC BY <br />�� <br />REAR SET9�� <br />�orNe� <br />� <br />OCCIIPANGY <br />P- <br />no D�`srAo� <br />N 1, <br />sueac�onen •-...._-"' "--.—. n <br />r�P �,� ����i- �ee �,� �% <br />4�-- <br />V�C�Ni$�IE FEEB VILUATION <br />o-�) OYES j�10 <br />IIOUP NO.OfOWELLINOUNli9 <br />3 BUILDINO : ��O' �' <br />g Mez. oca �o�o — <br />PLUMBIN� <br />MECH�NIGAL <br />❑ NO <br />— OTIIER <br />PENALTY <br />IS C�IECMEO BY I�PPR. FOR ISSUANCE OY <br />s� L G <br />TOTAL I <br />����� <br />..1 <br />iEE <br />9,�cr� `/d '• <br />