Laserfiche WebLink
Ns Everprs.•n <br />GITY OF <br />everett <br />BUILDING DEPT. <br />259-8745 <br />L_� � <br />�� <br />�;-�►PPLICATION Fdt�' ��«e„ <br />CaNSTRUCTlO� 0 <br />PERMIT <br />TO BE COMPLETED IN BLACK INK— PLEASE PRINT <br />❑ COMBINATION ❑ BUILDING ❑ MECHANICAL ❑ PWMBING ❑ SIGN <br />� � QM�I��DNE55 2 I� � v` CII i Q �`� ZIPLV 1 P�ll�l/1 ��T�O�O <br />_ � _ <br />GE1�EMlGONTR0.C10H MAILAD�FE55 Citt ZIP PNO��E IICENSE� <br />MECM�NIC�LCONTRACtOq M�ILA�ORE55 Cltt ZIP PHONE LILENSE• <br />PlUM91NOWNiR�CTOF M�ILA�DRE55 CIN ZiP PHONE LIGENSE• <br />:LI1550F WORN,�,� <br />❑ NEW IJ' ADDITION AL7ERATION ❑ REPAIR ❑ DElAOLITION ❑ WOODSTOVE/FFPL.INSERT ❑ BUILDING RELOCATION <br />IALU�iIONOFWONK�CO•u10FMRTERUl5PLU5UBOH1 � ^ p ^ <br />% U U <br />oescnieewoAK� ^� / ,�` ^ <br />� ��o� j w� ��� o c,�/ e a <br />iISE of BUILOINC. <br />LEfiAL pESC�TION�F PR� EflTY �SJ�O�� � N' DO �� F� U�'l � <br />3/ 3 " <br />r� /� v <br />�3q�- �6�-D��� <br />ECt�00PE55 <br />3 2O Z, �-(0 V <br />� co �i d— ���.1 �lau�S�t�Cx �dc�i <br />I HEAEBY ERTIFY THAT I HAVE READ AND EY.AMINED THIS AP- <br />PLICATIO ANDKNOWTHESAMETOBETFUEANDCORRECT.ALL <br />PROVISIONS OF LAWSAND ORDINANCESGUVERNINGTHISTYPE <br />OF WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HERE• <br />IN OR NOT. THE GR�INTING OF A PERMIT DOES NOT PRESUAIE TO <br />GIVE AUTHORITY?O V!OLATE OR CANCEL THE PROVISIONS O� <br />ANY OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION <br />OR THE PERFOFMANCE OF CONSTRUCTION. <br />SIGNPNFE OF GONiRACTOf� OR AIIT NIZED PGENT DAtE <br />X �����,.�.�,�._ ,.��D� �G�/ <br />9USINE55 LICENSF <br />/t� � � <br />FIRED <br />EA <br />TO�AL FEE S I ��._ � <br />THIS PC`RTION TO BE COMPLETED BY BUILDING DEPT. PERSONNEL <br />�nrmw ..O_SETBACN PLRNGN:GH IUMOER F ;LANCHE.N <br />_ <br />US[ZO�� r LOT�REA VPCANTSRF <br />�G� pYES OM� <br />J <br />ttPEOFCONST. OCCUPANGYC�ROUP NO.OFOWELIIM <br />V-N HDo�( ,�2 dJ.c, <br />1D <br />SiZE OF BLDO. NO. OF SiDRIES MAX OCQ LOAO <br />AaSv+� �72 S.F, ( ht.�. <br />BY <br />► <br />I�� <br />G .G <br />!,� `��; FEE <br />�✓ J i <br />FEES <br />, i i _ <br />BUILDING . s� <br />PIUMBINO <br />MECNANICAL <br />OTHER <br />PENALTY <br />TOTAL <br />3a63 RECEIPi NOO ! <br />�- � <br />VALUATION FEE <br />�1R�' `��- '.`�'� <br />�� <br />