Laserfiche WebLink
�PLICATION FO� <br />« «"'"' CONSTRUCTION <br />everett PERMIT <br />BUILOING DEPARTMENT <br />2b9•8745 TO BE COMPLETED IN INK • PLEASE PRINT <br />�� <br />e <br />O DEMOLITION p►COMBINATION ❑ BUILDING O MECHANICAL ❑ PLUMBIN(3 O SIGN <br />�E�� ( �LIIDDR�II� ZS S( CITY ZiP PMONE <br />N +h — �-}/EI�TT g 820! Z�-8'�"3 <br />MCNIIEGTON,C�ErlIONER M�II�ODflE33 CITY LIP PNONE <br />.. O �V � � � .._.�.---�_ <br />OEN[MICONiW1CTOR M111l�DORE93 CITV ZIP VHONE LICENSE• <br />MFCNIINICIILCONTMCTOR M�IL�OURESS � Cltt 21P PNONE LICENSE• <br />KUM\INOCONiRACTOR MI1IL�DDRE9S CITY ZIP PMONE IICENSE• <br />CM760F Wd1 <br />❑ WEW � ADDITION ❑ ALTERATIUN ❑ REPAIR ❑ OEMOLITION _❑ WOODSTOVE/FRPL.INSERT ❑ BUILDINO RELOCATION <br />ATION OF W011N I�T OF M�fERU1L8 PL W 11100M <br />coZT' o F -Ti���/�aTiuiJ � `i, o00 <br />:�K�K <br />E1 To7AL �ErJ I9vdOIFTien! P�u3 <br />or wx oira <br />�..if�F fRmtLY nu�1ELC.�n1ir <br />Z41 <br />-2 <br />N <br />��IIGN��O avt �v <br />s i g 1 I, 8is r r�v L� <br />'aliiMl 'T EJ(�sTi.J(r NO�Je BC�IQieM � <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS AR <br />PLICATION AND KNOW THE SAME TO BETRUEANDCORRECT. ALL <br />PROVISIONS OF LAWS AND ORDINANCES OOVERNINO THIB TYPE <br />OF WORK WILL BE COMPLETED WITH WMETHER 3PECIFIED HERE- <br />IN OR NOT. THE ORANTIN4 OF A PERMIT DOE3 NOT PRESUME TO <br />OIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS O� <br />ANYOTHER STATE OR LOCAL LAW REOULATINOCONBTRUCTION <br />OR THE PERFORMANCE OF CONSTRUCTION. <br />910N�TURE OF CONTR�CTOR OR AUTMOR12ED �OENT DATE <br />X o,�,.,,,.� �l . /�'i�,.�.Q <br />THIS PORTION TO BE COMPLETED BY BUILDING DEPT. PERSONNEL <br />z� S <br />LOTARE� V�GINTSITE <br />OO OYES ONO <br />OCCUP�pNGYGROUP NO.OFDWEL <br />R ' .�i � <br />FLAN9 CMECKED BY <br />GG <br />s�ln��s ��E� 1�� � <br />FFL/ VIILU�TION <br />BUILDINO <br />PLUMBIN� <br />MECMANICAL <br />OTMER <br />PEN�LTV <br />TOTAL <br />NEGEIPTNO. OCj 1 A�J � <br />6 r avC� <br />F![ , �� <br />� <br />- . - � - . .,:... <br />