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, _PPLIC�ITiUN FO�_ <br />In� Erupn�n C O h� ST R U CT 1'O N <br />GIfY Oi <br />everett PERMiT <br />BUILDING DEPAR7MENT TO BE COMPLETED IN INK • PLEASE PRINT <br />25� ti745 <br />❑ DEMOLITION ❑ COMBINATION ❑ BUILDING ❑ MECHANICAL ❑ PLUMBING <br />Men ernness arv nr rnom. <br />`"°`° p �UErzCTT �gZ03 �53'.2 <br />?r R R. P I E f2 R� �� �� � Q J2R�U L�Iv[t , c n nr rn:r.n <br />mr.mu�:iui�uts�.}rnn InuiAU0fik55 <br />everrll <br />� <br />❑ SIGN <br />O <br />�iL1A{PI (.�111IIIAI:IUI1 M�R �U[111055 <br />cm zir ��unrn ucuisi . <br />� ►;cnlwo�� o��es I�e, <br />I.IICII�//��:il CON111ACIa11 <br />MUL Aoon[Ss f.I1Y [�P IvoNL up.Ntil . <br />PI UI.IIIiN� i f.U1111UL�Up <br />I.I�ILAD[1f1C:5 CIIV ZIY YIIUflL IICLIHL• <br />f.l�S�(II NUlin <br />� NEW ❑ ADOITION ❑ ALTEflATION ❑ REPAIR ❑ DEMOLIiION ❑ WOOOSTOVEIFHPl..INSEHT DUILDING RELOCAIIOM <br />� <br />�o <br />,� 3 Be„av <br />� mu nr scn�r��o�� ov r <br />�oi 1�2mocr�.�- <br />x r) <br />--' �WAI <br />on <br />OBINNINGFOUNTAIN '- <br />(IOOF OFAIN <br />VACl1UtA BREAKERS _ <br />NOOF ORAINS-RAINLEpDERS <br />_ _ SINN:S[f7V�CF-UA�.ETC) _ <br />� I HEREBY CERTIfY THAT I HAVE READ AND EXAMINEO TIi1S AP� <br />'� PLICATIONANDI<NOWTHESAMET08ETRUEANDCORRECT.ALL <br />PROVISIONSOF LAWSAND ORDINANCES GOVERNING THISTYPE <br />OF WORK WILL BE COMPLETED WITH WHETIiER SPECIFIED HERE• <br />IN Ofl NOT. THE GRANTING OF A PERMIT DOES IJOT PRESUME TO <br />GIVE AUTIIORITY TO VIOLATE OR CANC[L TIIE PROVISIONS OF <br />, ANYOTHERSTATEORLOCAILAWREGULATINGCONSTRl1CTIOP! <br />OF TNE PERFORMAtJCE OF CONSTRUCTION. <br />SIG ATUREOFWN^�RACTORONAU7110PI2EDA(iLNf OaTE <br />'/ �% • <br />� % a"�j�/._¢�-- �� ---_I�UnL' ��,-!i�h� <br />ICANI'SGIIltlU51NE551i NSFNO v <br />OF <br />fEE <br />_'_ _ _ ____ / . '.D._ <br />-_.___ —.=L._.1 �.. <br />___'__ __- _LI_ - - <br />"-___ _"__ __ . .� <br />— s _ -�'J�..--- <br />f----- ----- <br />-- ---f —'� - -- <br />� TOTRL FEE _.. = I �S I I I .-..-_ . __ _ ___' — <br />_ __ I '--'_'.--"_ <br />THIS PORTION TO BE COMPLETED BY BUILDING DEPT. PERSONNEL —_ <br />PL�N CIIECN NUMOEB 19 �N CIICGK fkC <br />n.ia��e�lluCn ��I��SF1p�CM Si0E5EtBAQN f� ILLCIiPIIA- <br />2„ 'Ia G ��� �(e �l �- �E� �5;�.- ---'-7U`� �-��--- <br />u�.��:�rot / �OIa1�1lA/�'[/7� VAWy 7.611E FEE4 V�IWiION ____FEE <br />(j I /�2L.S�/ fHFS ONO _.. J._ <br />IY 'f� �a � � 1 i <br />h�9u�i��'��, OCfUPu�f.YG�OUP NOOF�W�ILINGUNi15 ,___,___..-- — - \ t <br />�V N 2�� BllIL01N4 s ___'_ .�--,�1 I J'�_ <br />"i:l J� bl l�u N�t Of $IORIES MAR OCG LO�D - . <br />/ �' PLUMDING ___ � ' ) - <br />%i�� SP -- ---- - <br />—� MECIIANIC�L __,��L'- � � - <br />fIHL SPRIHNLER$ REOUIR&D ❑ YES NO Oi11ER ____ _--- <br />� / /�) <br />VEIAL7Y _ _ _-'" <br />♦199i.:a�i�ll�4.f.tl� IYaNiCtlECNEOCY APP11fORISSUANCEOY / / <br />� TOTAL ___ _____l_��r- I�I,._ <br />�,�.. • J�� G . c . <br />