Laserfiche WebLink
`; .1�'PLICAT�O�d F�:c' <br />1h� Ever9�een c O N S T R U C T� O N <br />��n o= <br />evere�t PERMIT <br />BUILDING DEPARTMFNT <br />259•8745 TO BE COMPLETED IN INK- PLEASE PRINT <br />❑ DEMOL�TION ❑ COMBINATION ❑ BUILDING O MECHANICAL <br />�W��SLA�� (��fiGLP�jj�L°fEsf ��UP, 3fx?S' 13.ZN�41165! <br />e`�; �IIIECIOf10F51GtlEIt IAAILPOOf1E CIiY 21P <br />_�'L•� 19 i� 5 �U`lf'l�5% ��I�G. 1�(7P—A��t%7% <br />9[r�rn�lcorllnqc�01 _ n ranlLnot�it[SS � . �:Ilv _ ., Z�r <br />everett <br />� <br />�LUMBING O SIGN <br />ri�or+e <br />�e<<vv� l��3- 44s�x <br />PIIONE <br />PIIONE 4CENSE • <br />s6 � - 3�>.r <br />MECIIRIIICRL LONIf1A:I011 MAIL A0011@55 CIIY LII' YpUNt UGENSE • <br />PLVF18inOGOtliP�CiOR � MMl�U0�E59 CIIY ZIP PI�ONE LICENSE• <br />�NEW ❑ ADDITION ❑ ALTERA710N ❑ FEPAIR ❑ DEMOLITION ❑ WOODSTOVE/FFPL.INSERT ❑ BUILDING RELOCATION <br />vAlu�l�oN oF wonK �cost of 6iR� E n�a�s rLus LAooH1 <br />�oT_ <br />Pnaecr nooaess <br />77oi� F..Ve�9Qe�K <br />PLUMBING <br />NO. TYPE OF FI%' <br />� WATERCLOSET�iOILET) <br />BA7HiUB <br />LAVATORV IW�SH OA51��� <br />ShIOWER <br />KITCHEN SINK 8 DISP. <br />lISE IONE <br />TYP[ OF Cf <br />OF <br />��n <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS AP• <br />PLICATION A�JD KNOW THE SAME TO BETRUE AND CORRECT. ALL <br />oe�owonarT.c��vouaeoriesi PROVISIONSOFLAWSANDORDINANCESGOVERNINOTHISTYPE <br />OF WORK WILL BE COMPLETED WITH WHETHEFi SPECIFIED HEFE- <br />IN OR NOT. THE GRANTING OF A PFRMIT DOES IJOT PRESUME TO <br />GIVE AUTHORITY TO VIOLATE OR CAPJCEI THE PROVISIONS OF <br />ANY OTHER STATE OR LOCAL LAW REGULATING CO�:STRUCTION <br />OR THE PERFORMANCE OF CONSTRUCTION. ` <br />SIQNATUREOFCONiRACTOROFA iHORIZEOAGENT DATE /^26��� <br />x�.,// _. /� �-,./.. - — - —^ - � <br />OF <br />T <br />THIS PORTION TO BE COMPLETED BY BUILDING DEPT. PERSONNEL <br />IIERRSE�04CN S�DESE�E�CN PLRNGNECNNUMOEII PLANGHECKFEE <br />F[E RECEIPT NO <br />101A11E4 VACRNTSItE <br />❑YES CIND FEES VALUATION FFE <br />OCGUPr1NCYGROUP NO.OFOWELLINOUNIIS <br />4PPR. ipp ISSURNCE 8Y <br />BUILDING 1 <br />PLUh101NG <br />MCCI I�NICAL <br />OTHE{i <br />PENAITY <br />TOTAL <br />.� � <br />0 <br />