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.:� � <br />.. everett <br />� pppE.ICATIarI FOR CONSTRUCT�JN PERMIT � <br />TO BE COMPLETED IN INK—PLEASE PRINT <br />0 <br />- <br />m« c: e,a�ea� <br />C�TY OF � <br />evQrett <br />BUI�DING DEPARTtJ�ENT <br />259•8610 <br />DEMOLITION i COMBINATION <br />GWNEH MAIL�DDRES� <br />Q'AG`C,� M�kADDRf 5 <br />TEN 1 _ /: <br />8/i - /3 <br />�q ITECi0ADC6�GNE ADDRE55 <br />7 <br />-----�--_— <br />HEATING SYSI EM: "� GAS O ELECTRIC ❑ <br />! BUILDING <br />MECHANICAL ! � PLUMBINO <br />, IiCENSE • <br />i SIGN . _., <br />S <br />c�esSOFwOnK . ' WOODSTOVE/FRPL INSERT �. i BUILDINO RELOCATION <br />NEW I'� ADDITION � A�TEFA710N i REPAIR _ I DEMOUTION <br />CONr�Gi r[nsoN AHD���OMC No <br />vROPOSEnux�+nunv��•.+ � <br />, ���._�__— <br />IFMlDESCPIPTqN ERTYISHO BELOW09A���CNFOUnC iE51 <br />LOT BLGCK �F _-- <br />VNQIELT <br />FOR OFFICE USE ONLY: <br />FROMSEfB�CN AE�NSEiBACY. _ <br />use zor+e wT �i+e� <br />IYPLMCONIS.�l�O�'��IE 7YVI)fGONSI.�tlt <br />6iZE0FBlD0 NO.OFS1lWiE5 <br />r.n�ue�wv i n�lf FIHE 6PANIlIEIY; <br />_ <br />I HEREBY CERTIFY THAT I HAVE READ AND E%AMINED TNIS <br />PROVISIONS OF �LAWS AND ORDINANCES 00 ERN NO THRS TYPE OF <br />NOT. THE`GRANT�NG OF AD ERMIT DOES NOT PR'ESUMEETO OWE <br />AUTHORiTv 70 VIOLATE OP CANCEL THE PHOVI610NS OF ANY <br />OTHER STATE OR LOCAL LAW REGULATINO CON57RUCTION OR TME <br />PERFORMANCE OF CONSTHUCTION. THAT I AM AUTHORIZeO 8Y THE <br />pWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH <br />APPLICATION IS MADE AND I COMPIY.WITH THE S?ATE <br />yI��TRR O�fOCCM)IRnGyTCN�CHI�RHORZED zE6T2�DTnE. <br />�f�//,I�`�.� __N"y ' . <br />•ppLIC�NTS CITY BUS�NESS ULENSE NO MlD BUSiNE55 NHI <br />T <br />FAN <br />� SM1� .ciHACN -- � PLINCHEC✓NVMBP+ <br />wcu+i sire fEE� <br />BN�UING <br />occu�.�.• xoamar��wurin �"-- <br />��w" PLUM0ING <br />BASCMENi MECMRNICAL _ _ _ <br />p MEK.NT lIMI1�TION APDITIONAL PLAN fMECk <br />pTHER <br />S1ATE BU�LDWG SURCHAROE <br />CITY OF EVEHETT PUBLIC WORKS <br />LO�AL8ALES <br />7�� 1111C IR 91�5 TOTAL <br />:� <br />1 <br />_—__.�- .—T"_ <br />� <br />