Laserfiche WebLink
G E„�,�„ APPLICATION FI.R <br />CONSTRUCTION <br />everett PERMIT <br />BUILDING DEPARTMENT <br />259-a�as TO BE COMPLETED IN INK • PLEA�E PRINT <br />O DEMOLITION ❑ COMBINATION UILDING �'I�AECHANICAL � MBING ❑ gI�N <br />f <br />M.111 �OORESS <br />� <br />�� � <br />v - -- ��wc LICENSE • ' <br />PWMBINCaCONTR�CTOR M�Ilh0�PE55 CITY IIP PIIUNE LICENSE� <br />❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ DEMOLITION ❑ WOODSTOVE/FRPL.INSEfli ❑ BUILOING RELOCATION <br />..___......_�CC. GdO.m.. -c,...,..,,.,..o,,,.� <br />OESCRIBE WONK <br />l��r�<; .�rs:�J��•��^ <br />use ov euuoiNc , <br />US[ <br />� <br />U /� 1 <br />SIZE Of BIpG <br />.,i� % � + <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS AP• <br />PLICATION AND KNOW TME SAMETO BE TRUEANDCORRECT. ALL <br />BEIOWOP�TT�CHiOURCOPIEEI pROVISIONSOFLAWSANDORDINANCESGOVERNINGTHISTYPE <br />OF WORK WILL BE COMPLETED WITH WHETHER SPECIFIEO FiERE• <br />IN OR NOT. THE GRANTING OFA PERMIT DOES NOT PRESUME TO <br />GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF <br />ANY OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION <br />OR THE PERFORMANCE OF CONSTRUCTION. <br />SIGNATIIflEOFCONiFRCiORORAUTHOflIZEDAGENi DATE <br />T-�>s zq� <br />� <br />NO. <br />M <br />THIS PORTION TO BE COMPLETED BY BUILDING DEPT. PERSONNEL <br />RE�R SEiB�LN <br />O�S , <br />lOfROEn— <br />OCCUPPNCVGN� <br />��..3 <br />NO OF SiORIES <br />J� <br />.)� � <br />V�CnNT SIIE <br />t� ES pN0 <br />N0. OF DWELLING UNITS <br />� <br />M�K OCC. lOAO <br />i. tONI55U�11GE BY <br />✓' <br />T �:;- <br />� % /li��i FEEI���lS <br />�r� <br />_:���__ <br />FEES V11lU�TION <br />BUI�DING <br />PLIIMBING <br />MECIIANICAL <br />OTHEfl <br />PENRLTY <br />TOTAL <br />S <br />RECEIP7 NO <br />FEE <br />wilh zorirg. SEPA ar.J cliscr�tionary `".�",i �`•7 „ <br />l,.// � � <br />pern:it rcq;:ii�ra��i�is. a5-�°�QK^� <br />��� / ,�/ <br />�/�j ¢(e vr��s'1 y. irtt <br />BY �Fd3nr.i:; G_;.t.-- D�t'-%� �e.�e�` fi( e <br />i.�..'/,% na <br />