Laserfiche WebLink
����APPLICATION F(,.:t <br />�hs eve�0�een C O N 5 T R U C T I O N <br />cin ov <br />everett PE RM IT <br />BUILDING DEPARTMEtJ�i <br />259•8745 TO BE COMPLETED !N INK- PLEASE PRINT <br />❑ DEMOLITION ❑ COMBINATION ❑ BUILDING Y�MECHANICAL <br />�os�n WA <br />O PLUMBING <br />everetl <br />� <br />❑ SIGN <br />nnwu�ec� ono�swr+en �a�a nooness • cm ��� •����_ <br />OENEO�LCONTMCIO� IAILAOOOESS LiTY ZIV �MONE LICENSE• <br />xoennnn.0 w.....�......� <br />�Ic�111µT-'ST �.�ERI;/ �i�+=n�lS 2of'�IS'r�"L�-�' A�/F. � <br />21P <br />z�� <br />29d'6 <br />❑ NLW ❑ ADDITION CM ALTEF7ATION ❑ REPAIR ❑ DEMOLITION ❑ WOODSTOVE/FRPL.INSERT ❑ BUIIDING RELOCA710N <br />va�u.+rio�+or wonK�cost or unicnints i•ws uooai <br />St��f-� nnEj r�t. �r �c7- wauc <br />se or ouaou�a <br />��n` SiV� 5���.5 <br />=nni ooscnirrror� or rnorE��rv�sr�owr+oe�ow on <br />�or_ <br />naecr aooness <br />f��� r� <br />TVPE OF <br />ORINKING <br />rioo� oa <br />VACUUM [ <br />�� <br />4�f � �/� <br />I HEREBY CERTIFY TFIAT I HAVE FEAD AND EXAMINED TN�S AP• <br />PLICATION AND KNOW THE SAMc TO BETRUBAND CORRECT.:ILL <br />PROVISIONS OF LAWS AND ORDINANCES �OVERNING THISTYPE <br />OF WORK WILL BE COMPLETED WI7ii WHETHEF SPECIFIED HERE- <br />IN OR IJOT. THE GRAI�TING OF A PERMIT DOES NOT PRESUME TO <br />GIVE AUTHORITY TO VIOLATE 017 CANCEL THE PROVISIONS OF <br />ANYOTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION <br />OR THE PERFORMAMCE OF CONSTRUCTION. <br />SIONAiURE OF CONTRACTO R AUTHORIZED AGEN7 DATE <br />X �s�flj� ��T"/�-� <br />N0. <br />LiCENSE N0. <br />M <br />THIS PORTION TO BE COMPLETED BY BUILDING DEPT. PERSONNEL <br />fRONi5E1�nCR REAlISGBA^K SIOESEIOACK PLANCHEGKNUMOER PLANf.HECKFEE <br />FEE FEGEIPI N0. <br />USE 20��E l01 N�I.A V�f.ANT SIIE <br />FEES VALUATION FEE <br />❑YES pN0 <br />TYPEOFCONST. OCCUPANCVGROUP ��OAFOwELLINaUNII9 <br />SI2E OF OLOG <br />APPLIG4IIONnCC �Y <br />NO O� SIOIIIES <br />r�nu, <br />FORISSU�NCEDY <br />�' �� � <br />BUILDINC S <br />PIUMBIIJG <br />MEC4IANICAL <br />OTHER <br />PENALTY <br />TOTAL <br />i :. <br />FEE <br />