Laserfiche WebLink
„PPLIC�►TION FO.. ���,�„ <br />'m« ”" CONSTRUCTION O <br />everett PERMIT <br />TO BE COMPLETED IN BLACK INK— PLEA9E PRINT <br />iUILDINQ DEPT. <br />!69-8746 ❑ COMBINATION ❑ BUILDING ❑ MCCHANICAL ❑ PLUMBINO ❑ 8101� <br />�NNER M�ILAODRE99 CITY ZIP PNONE <br />Georee Gartrell 6031 Flemin8 Rd E�erett 98203 353-1531 _ <br />rny <br />�ENEMLCONTN�CTOR M�ILApDRE59 GIY LIP - PHONE 4CENSE• <br />ZIP <br />LUIM�NOCONTR�CiOR M�'LAOCHE89 CITY ZIP PNONE LICENSE• <br />�L�lS OF WORK <br />❑ NEW ❑ ADDITION C� ALTEFATION C� FEPAIR ❑ DEMOLI710N ❑ WOOD9TOVEIFRPL.IN9ERi ❑ BUILDINO RELOCAiION <br />+�u ioNo O�KI OlfOfM�TlPi�I�PIUlI�lOII� <br />948.00 - <br />�iscnue woeK <br />or_ <br />6031 Fl�ning Rd <br />�VPE <br />32E OF BLDO. <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS AP- <br />PLICATION AND KNOW THE SAME TO BE TRUEANO CORRECT. ALL <br />BELOWOR�TT�CHFOUPGJPIEW PROVISIONSOFLAWSANDORDINANCESGOVERNINaTH13TYPE <br />OF WORK WILL BE COMPLETED WITH WHLTHEq SPECIFIED HEFE- <br />IN OR NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO <br />GIVE AUTHORITY TO VIOLATE OR CANCEI THE PROVISIONS OK <br />ANY OTHER STATE OR LOCAL LAW REG ULATING CONSTRUCTION <br />OR THE PEAFORMANCE OF CONSTRUCTION. <br />SIONAT'I:�S'OFCONTRRCTORORRUTHORRECIA�ENT DATE <br />X <br />Wa 98203 <br />T <br />THIS PORTION TO BE COMPLETED BY BUILDING DEPT. PERSONNEL <br />PERR <br />lOTARER <br />SIDE SETB�CK <br />VACANTSITE <br />OYES ONO <br />C�� G. BY I PLRtlS GNEGKED BY IAPPR. FOR ISSUANCE BY <br />BUILDING <br />PLUMBING <br />MECNANICAL <br />OTNER <br />PENALTY <br />TOTAL <br />FEE RECEIPT NO. <br />FEES V1ILURTION FEE <br />s �lI�Q'�^ . <br />