Laserfiche WebLink
G f�,,,.M, � Ar�PLICATION FORr✓ <br />everett / CONSTRUCTION <br />�?�'� �!✓�` � TO Be COMPLEP E R M I T PLEASE PRINT <br />BUILOING DEPT. /_ ''.Cv"� <br />259-8745 �'`�- ❑ COMBINATION � BUILDINO ❑ MECNANICAL <br />���roM <br />e <br />❑ PLUMBINCi ❑ SICN <br />PLIIMBINOCONfMCT0i1 M�Il+1DDPES3 CITY 21P PNONE LICENSE� <br />� NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ DEMOLITION ❑ WOODSTOVE/FRPL INSEqT ❑ B:IILDINO RELOCATION <br />v�LU�1/10N OF WORK �COST Of M�iER1�L3 PLUS L�BOR� <br />'�/.�.%S. lSi�. � <br />oEScnleE K , <br />� <br />�UNI <br />BEIOW <br />`Z <br />i <br />FU(TURc <br />I HEREBY CERTIFY THAT I HAVE READ AND E%AMINED THIS AP- <br />PLICATIONAND KNOW THE SAMETO BETRUEANDCORRECT. ALL <br />PROVISIONSOF LAWSAND ORDINANCESGOVERNING THISTYPE <br />OF WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HERE- <br />IN OR NOT. THE GRANTING OFA PERMIT DOES NOT PRESUME TO <br />GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF <br />AMYOTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION <br />OR THE PERFORMANCE OF CONSTRUCTION. <br />SIONATUREOFCONTR�CTORORA HO ZEDAGEHT OAiE <br />N0. <br />THIS PORTION TO BE COMPLETED BY BUILDING DEPT, PERSONNEL <br />:C IONE �� <br />R-s <br />�'E OI CONSi p( <br />��� <br />![ Of 9L00 N( <br />2z1 it-3 /o/i µ , <br />�n� �' <br />i z,+�9 ` <br />'UC�IION�CG BY IPUNSCNCChEDBY <br />��� J� <br />/ <br />% �Z � cee � �9 nccci � o <br />VAC�NT SITE �� � �� � � � � ' �� �� <br />M'[S�ah� FEE9 V�IU�T"+N FEE <br />N0. OF OWELLINU UN179 <br />/ Bl11LUING , f'^Z 111M. � <br />MA%. OCC. IO�D W V <br />PLUMBING � n � <br />-�. <br />MECHANICAL C <br />OTMER <br />PENFLTY <br />�PPP. FOR �SSU�NCE BY ' <br />T°T�� I ssz v <br />�.c <br />'Vo �ts�4. SMI�IA. �G�7 'ZS FT <br />h{beutc 'L�E 1a�6z,l.at�.e �3...�1r,s�rios) <br />AT 'Ct� Ft�o-L- o r'R� F�.rx�, . <br />