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';:,.. <br />; ° <br />IM Ernpnln <br />aroF <br />` �everett <br />BUILDING DEPARTMENT <br />269•8745 <br />,..' ❑, <br />ECTORGEB�aNEH • � , <br />.. .a •�,.�,_ <br />d�LCONTPACTON � ' � <br />�w7���' � 4 <br />'�PLICATION FO� <br />CONSTRUCTION <br />PERMIT <br />TO BE COMPLETED IN INK- PLEASE PRINT <br />NATION O BUILDINQ .,. O MECHANICAL •,�', '„ ❑ <br />everen <br />e� <br />,. 0,8ylON <br />Z b1SJ,�� <br />.MC4MMIGI�L}.VIOrv�p�Vq , mnn.npvnwa �.n� � ur �n�nc 4GCtltlE• <br />r, Zf` l . . <br />.� <br />� PLUMlINOCONTMCTOR M�ILADORE59 . Cltt 21P VNONE UCEN9E• <br />NEW ❑ ADDITION ❑ ALTERATION ❑ REPP.IR ❑ DEMOLITION ❑ WOODSTOVE/FRPL.INSERT ❑ BUILDINO RELOCATION <br />�� ;,� �'.��..., <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS AP- <br />PLICATION AND KNOW TH E SAME TO BE TRUE AND CORFECT. ALL <br />PROVISIONS OF LAWS AND ORDINANCES OOVERNIN6 THIS TYPE <br />OF WORK WILL BE COAfPLETED WITH WMETHERSPECIFIED HERE• <br />IN OR NOT. THE CaRANTINQ OFA PERMITDOES NOT PRESUME TO <br />GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OK <br />ANYOTHER STATE OR LOCAL LAW REGULATINO CONSTRUCTION <br />OR THE PERFORMANCE OF CONSTRUCTION. <br />SIONATURE OF CONiRACTOR OH AUTHORIZED AQENT �' DATE <br />X L�/ • / f I// � / �. / � � <br />THIS PORTION TO BE COMPLETED BY BUILDING DEPT. PERSONNEL <br />REAR SET�B`ACK SIDE SETBACN PLAN CNEC NUMBEP � LAN CNECM <br />�/ ���JiCyr� S�(�j �� � �� �I �Q/h� FEE� � ECEII <br />LOTARE� `J <br />V�C�NTSIfE FEEE VAlU11TION <br />��.S �YES ONO <br />ONBT. N0. OF �WELLINO UNITS <br />�- "' ' ` � ' BIIILDIN� <br />MAX OCG. LOAD <br />PLUMBINa <br />MECHANIC�I <br />OTHER <br />��5�� <br />OCCUVANCYGROUP <br />a <br />F!E <br />TOTAL ' b <br />L . G . �,,yt.G� 3f/�,atic. uD7 �n <br />25 � � JSv,F ¢,oc�e <br />�A-p,ea sT ��T eac '�,,oc� <br />. <br />,^r ^^:r-; ,., --�• •,— <br />...�.\ry_ �:r'. ....`!:_.Yt���}.. �if.. _i4 �11:'U...�.� �� ��'Y"�,_`bvD:.Q7l.ai .!'.. ;�':�f�. <br />