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, .PPLICATION FO►_ <br />,".E".`°`"° CONSTRUCTION <br />CIIV OF <br />everett PERMIT <br />BUILDING DEPARTMENT <br />259•a�45 TO BE COMPLETED IN INK - PLEASE PRINT <br />❑ DEMOLITION ❑ COMBINATION �.BUILDING ❑ MECHANICAL <br />M�IL �D�qE55 ��T'� Z�P <br />�• l3m'1 �� GOl/ ula*-/ N�. �l'! <br />'IGNER MRILAODRE53 <br />� p�kz�S �B12 N�wlTi <br />�Tpq�� � MFIL�; POE'S� �� <br />u� <br />❑ PLUMBING <br />�rr l,� • <br />Nas, u}',� • 9P <br />everett <br />� <br />❑ SIGN <br />�s a5�-���� <br />LICCNSE • <br />PuG�iwc IA� I� <br />MECII�NIGLCONTPACTOq MRI�AOOflE55 CITY ZIP PHCNE LILLBSE• <br />PLt1M6iNGCONTPACTOH MAILAO�flE54 CIIY 21P PHONC LICENSE� <br />NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ DEMOLITION ❑ WOODSTOVE/FRPL.INSERT ❑ BUILDING RELOCnTION <br />P�1Te w$ � <br />lE6�L OESCFIPTION OF PP <br />iot—e�oc�— <br />�J.G � <br />� <br />2 I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS AP- <br />� PLICATION AND KNOW THE SAMETO BETRUEANDCORRECT. ALL <br />NOHATi�CMFOU GOPIES7 PROVISIONSOFLAWSANDORDINANCESGOVERNINGTHISTYPE <br />OF WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HERE- <br />IN OR NOT. THE GRANTINCa OF A PERMI7 DOES NOT PRESUME TO <br />GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF <br />ANY OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION <br />�THE�^ OR�Ati9NCF�OFCONSTRUC?ION. <br />SI IAIUflE�ur C T t�TOP� n�HORIZED AGENT D4TE <br />CITY 8USIN�SS IICEflSE NO. <br />/ �C <br />THIS PORTION TO BE COMPLETED BY BUILDING DEPT. PERSONNEL <br />USE20NE LOTAREA <br />C�� <br />hPEOFCONST CCCUPANCYGPOI <br />� -�/ �3 • z <br />SKEOFBLDG. NO.OFSTORIES <br />t �6,e� <br />V�CANjSJTE <br />OYES L�k10 <br />OCG LDAD <br />�. A <br />APPlIU110N ACL BY PLANS CMECHED BY ��PR. FOR issunrv <br />��� , l�j� _ � � � <br />��/I �^'p(�� I FEE S�� � I flECE1PT N0� �% <br />� V013 0 <br />FEEB VALUATION FE! <br />euuoina s�7s��+' � ��'Z <br />rwMou+a <br />MECMANICAL <br />OTHEfl <br />PENALTY <br />TOTAL <br />Pc.�4, M� � �ZE�7 T� r3ef <br />6/bt,e�� PJf ,�K�iuE <br />�-�9G�S <br />