Laserfiche WebLink
�-.PPLICATION FO`. ' <br />r`�'°'"" CONSTRUCTION <br />everett PERMIT <br />BUILDING DEPARTMENT <br />259-8745 TO BH COMPLETED IN INK • PLEASE PRINT <br />❑ DEM:�LITION ❑ COMBINATION ❑ BUILOING �MECHANICAL <br />OWNEN <br />�i <br />M�IL <br />CIIY <br />❑ PLUMBING <br />ereree <br />e <br />O SION <br />OLUMBiNOCONIN�CtOR M1111��ONE55 CITY ZiP PI�ONE IICF��if • <br />_.. .. _ . _.. p.�( <br />EW ❑ ADDITION 6L ALTERPTION ❑ REPAIR ❑ DEMOLITION ❑ WOODSTOVE/FRPL.INSERT ❑ BUILDING RELOCATION <br />vu u�nnM O[ wl�CN if1151(1[ M��L RIII S PlUS L�BORI <br />• ic�r - <br />lEO�I �E <br />tt^E OF <br />� <br />DISP. <br />1 HEREBY CERTIFY THAT I NAVE RE�D AND EXAMINED THIS AP� <br />PLICATION AND KNOW THE SAME?O BE TRUE ANDCORRECt. ALL <br />OR�Ti�GHfOURCOPIE�I PROVISIONSOFLAWSANDORDINANCESGOVERNINGTHISTVPE <br />OF WORK WIIL BE COMPLETFD WITH WHETHER SPECIFIED HERE• <br />IN OR NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO <br />GIVE AUTHORITV TO VIOLATE OR CANCEI THE PROVISIUNS OF <br />ANY OTHER STATE OR LOCAL LAW RE�.ULATING CONSTRUCTION <br />OR THE PERFORMANCE OF CO UC110N. <br />SIGNATURE OF f TOF O� A OR2ED AGENT DA1E <br />X �� �:�� -�.�_ F� <br />f <br />FEE <br />COND. <br />THIS PORTION TO BE COMPLETED BY BUILDlNG DEPT. PERSUNNEL <br />PE�RSEIB�CN SIOESETB�CN PL�NCNECKNUM9ER P�AqCNELN <br />w��Ne� V�C�Ni51TE <br />❑YES �NO <br />OCCUP�NCYGROUP NO.OFOWFLLIN6UNIT5 <br />NOAi S10RIES M�%.000. LOAO <br />9ED O VES ❑ NO <br />PL�NSCIIECNEDBY APPR FORISSUANGEBY <br />FEE AEGEIM NO <br />FEES V�LII�iION �EE <br />BUILDING = <br />PLUMBING <br />MECIUNICAL l(J <br />OTHEP <br />PENAITY <br />TUTAI �/) <br />4 <br />