Laserfiche WebLink
m. er.rprMn <br />GIfY Of <br />everett <br />BUILDING DEPARTMEMT <br />259•8745 <br />�PPLICATION FO.. <br />CONSTRUCTION <br />PERMIY <br />TO BE COMPLETED IN INK- PLEASE PRINT <br />❑ DEMOLITION ❑ COMBINATION ❑ BUILDING ❑ MECHANICAL �PLUMBiNCi ❑ SIQN <br />OWHEP _ _ _ M�IL��ORE9S CITV ZIP PIIONE <br />OENER�I GONTR1CiOR /� MML �ODRE55 CiiV ZiP PNONE LILENSE • <br />S'f 0 Y1N S (. r'�'N •4�YrI C�i �r� <br />MECN�NIL�LCONTP�LiOq M�II��DeE95 CItY IIP PHONE 4CCNSE• <br />PIUMliNfICON1R�CTOR M�ILAOORE99 CiTY I�P 0/L P���NE UCENSE• <br />T�i¢KAR P�d/l4�A/� 29Z3- 5i�..vi�rz �RtSi G14� i3orHF'� •''3%�7/7 nraKA••�sv� <br />oi�u or woeK <br />❑ NEW �ADDI710N ❑ ALTERATION ❑ REPAIR ❑ DEMOLITION ❑ WOODSTOVE/FRPL.INSERT ❑ BUILDIN6 RELOCATION <br />OF <br />DESCRiBE WORK <br />.� <br />CONSI <br />512E OF B100 <br />L�BONI <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS Ar'• <br />PLICATION AND KNOW THE SAMETO BE TRUEAND CORRECT. ALL <br />PROVISIONS OF LAWSAND ORDINANCESGOVERNING THISTVPE <br />OF WORK WILL BE COMPLETED WITH WHETHERSPECIFIED HERE• <br />IN OR NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO <br />61VE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF <br />ANY OTHER STATE OR LOCAL LAW RE6ULATI N6 CONSTRUCTION <br />OR THE PERFORMANCE OF CONSTRUCTION. <br />SION�TURE OF CONTR�CTOR OR �UTHOR�2ED �OENT <br />X �%% e D.�/% _ _ <br />D�TE <br />/i i�-86 <br />THIS PORTION TO BE COMPLETED BY BUILDING DEPT. PERSONNEL <br />P[ARSEIB�CN SIDESET9�CK PL�NGNECNNUM6Ef <br />LOf�HE� y�CANT5ITE <br />FEE! <br />OYES ONO <br />�CCU��NGYGROVP NOOFOWELUNOUNIIS <br />BUILOINO <br />NO Of SIORIES M�%. OLG LO�� <br />PLUMBING <br />MECNANICAL <br />7[D ❑ VES ❑ NO <br />OTHER <br />PEN�LTV <br />h1���5G11ECNE00V �PPRFORISSO�NCEOV <br />TOT�I <br />iEE � AECEIPt NO <br />V1ILUATION � FEf <br />