Laserfiche WebLink
�:PPLICATION FOk�' ���,�„ <br />'".E"'°'"" CONSTRUCTION e <br />GITY UF <br />everett PE�MIT <br />6UILDING DE�ARTMENT <br />259•8745 TO BE COMPLETED IN INK- PLEASE PRINT <br />❑ DEMOLITION ❑ COMBINATION ❑ BUILDING ❑ MECHANICAL ❑ PLUMBING ❑ SIGN <br />owr�en Mea �ooness crtr nv eyaaF <br />YleCc.i» � 5��•�� C`orsl P�'lTeX S9� �$%ab.a �8.�sb� GS3�o�.5- <br />INLNrtEGiOP0E9ONER M�R�O�RESS CItY ZIP C��OI�E <br />GEHEA�LCONiR�C10N MAl1,ADORE59 CItY 2�P AONE ��m f LILE�E• <br />�-.•.R ��-cL Q,G'-0va- /'1 � � % � P� <br />MECNIIN�GLCONiRACfOq MAIt��ORE83 LIfY I�P FIIONE LiCENSE• <br />QJ L�BSC� �� I /1 Vl <br />PLUMBMOCONIMCfON MML�ODNE59 GItY 2iF VIIONE LICENSE• <br />�GAORN <br />NEW ❑ A�DIiION C� ALTERATION ❑ REPAIR ❑ DEMOLITION CI WOODSTOVEIFRPL.INSERT ❑ 6UILDING RELOCATION <br />LEO�L OER <br />ioT �/ <br />SEiBACK <br />� <br />Of CONSi. <br />C� <br />G f ! �C- 7 <br />��/ i�v� l <br />I HEREBY CERTIFY THAT I HAVE PEAD AND EXAMINED THIS AP- <br />PLICATION AND KNOW THESAME TO BE TRUE ANDCORRECT. ALL <br />PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE <br />OF WORK WILL BE COMPLETED 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 />ANYOTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION <br />OR THE PCRFORMANCE OF CONSTRUCTION. <br />SIGNATURE OF CONTRRCTOB OR AUTHORIZED AGENT DATE <br />X.�I.�.. ��:v_.�., lo%/�'� <br />9US�NES9 ULENSE NO. <br />FAN <br />n] <br />THIS PORTION TO BE COMPLETED BY BUILDING DEPT. PERSONNEL <br />HEAN SElBAGN SIDE 5EiB�CN PLAH GNECN NUMOER /^ �LpN CN[CN IEE /� ' <br />1 � / � '�D�� /EF. /v �[CEIPINO i) y <br />- �'��i.�- �-� �..c. <br />I���^�t� I`�CAN�SITE I-� I V�{W�TION I FEE <br />I <br />1[U] <br />P��NS <br />�i -M � � �� <br />� <br />M�t OCC. IOAD <br />APVP.FORISSUANCE BY <br />(. • L' <br />BUILDIN� <br />PLUMBINO <br />MECHRNIGAI <br />OT11ER <br />PENALTY <br />TOTIIL <br />ea <br />