Laserfiche WebLink
IR� Ewryrwn <br />CIYY OF <br />-;,a,verett ' � <br />-- S <br />����'PLICATION FOk-� <br />CONST.RUCTION � <br />PERMIT <br />TO BE CUMPLETED IN BLf. K INK- PLEASE PRINT <br />everett <br />e <br />BUtLDING DEPT. <br />258•8745 ❑ COMBINATION ❑ BUILDING ❑ MECHANICAL �. PLUMBING ❑ SIGN <br />OWNER MML�OORE54 Cltt 21P . PIIONE � <br />NRIGM.ON ft ASSOGIq?E �j725 3RD AVE �,IE SUI'TE 8ao SEA'fTl.b WPc 9b168 52�- ZoBS <br />MCNITEGTOPDESIONEII M�IIA��RE54 Gitt ZIV ' PNONE <br />OENEPoILCONTR�CT08 MAILADOPESS CITY ZIP PHONE �ICENSE• <br />i <br />MECN�NIL�LCONip�CT00 _ MhILADDPE99 CITY lIP PHONE , „ LICENSE� <br />, ..� ii � � � (', � . <br />PLUMBINGCONTMCiOR M�ILAOORE95 �. CI7Y . � . ZIP � PNJNE 76j�qf,Qp UGENSE• <br />NvA�L90NA1.b r,�� �, 11063 FqUFIG N1GNway SoutH SEn7Tl.E Wk °I8i6B NhCDpM ?�1$�'9 <br />c��ss or wonK�p � � <br />❑ NEW r�l ADDITION ❑ ALTERAT�ON ❑ REPAIR ❑ DEMOLITION ❑ WOODSTOVEIFRPL.INSEfi' �'❑ BUILbING REIOCATION <br />Y�LUATION OF W0111( IC04T OF M�7EPI�lS PLUO LABOiry <br />PWf'WINS FOR 9G_LI : SEWlIG65 'f�IJkNT . lDU L.EVEL OF EV�RE7 �L14U. bFFfGE P�M.Ic (f�Rs? �, <br />. <br />USE OF 6UILDINO <br />lEO�L DESCPIP711 <br />�oi_e�oc <br />� . <br />JJEGTA�DRE55 <br />�eb S6 <br />:� <br />I HEREBY CERTIFY THAT 1 HAVE FEAD •. :D E%AMINED THIS AP- <br />PLICATIONAND KNOW THESAMETO BETRUEAND COFRECT. ALL <br />PROVISIONS OF LAWSAND ORDINANCESGOVERNINGTHISTYPE <br />OF WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HERE- <br />IN OR NOT. TNE GRANTING OFA PERMITDOES NOT PRESUME TO <br />GIVE AUTl10RITY TO VIOLAT£ OR CANCEL'THE PROVISIONS OF <br />ANYOTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION <br />OF THE PERFORMANCE OF CONSTRUCTION. -� � <br />SIGkATUfI! OF CONiRACTOR OR AUTNORIZED AGENi UATE <br />X <br />MkLL <br />� <br />THIS PORTION TO BE COMF'LETED BY BUILDING DEPT. PERSONNEL <br />