Laserfiche WebLink
L <br />� <br />In� Ernprw n <br />cin oF <br />everett <br />BUILDWG L'FPARTMENT <br />259•8745 <br />�PPLICATI�iV FO..�' <br />COIVSTRUCTiON <br />PERMIT <br />TO BE COMPLETED IN INK - PLEASE PRINT <br />❑ DEMOLITION ❑ CONIBINATION ❑ BUILDING ❑ MECHANICAL ❑ PLUMBING ❑ SIGN <br />OWNER (] � Mtll n00R: SS 1/ LIiV ZiP P�IONE <br />AP�CMIi�TOfl'�NtU qMJ pCf�AtN15. C�3ooncss���1 f�7D.� �.V�crcT7 a�20`i p3S3-qo�� <br />GENFRALCONTRACTOR \IAR A�011E55 C�tt IiP PI�ONE IILENSE • <br />Ru.N'� I-�!�mmtk, � 1321� �$Isi- A�e. N.0 �kt2�i r.1G�ru�J q�s�2,3 [.,s-v. aa�t l�.e.NsN�- <br />MECII�NILAICONTR�CiOfl MAILAOOR[SS CIIY ZIP P�..N[ II�ENSE��� <br />PIUMBINGCONTP.IGTOP MAIL�ODRESS CiiY 2iP N�ONE LiCENSE� <br />C1�55OF WOPN . I <br />❑ NEW ❑ AODITION ❑ ALTFfiATION ❑ REPAIR ❑ OEMOLITION ❑ NOOOSTOVE/fRPLWSERT ❑ BUILOING RELOCATION ,I <br />VAWATION OF WORN �COSi OF MAT[RIALS PWS UBOflI <br />�' 20 OC`�� I <br />n-sceioe w�onK <br />1��A� IlMwn�ri. �/Qi.ii 1� .I <br />NO. i TYPE OF <br />fqONTSC'JACM <br />115E ZONE <br />-1NK8 UISP. <br />�S <br />I HEREBY CEFTIFY THAT 1 hIAVE READ AND EXAMINED THIS AP- <br />PLICATION AND I(NOW THE SAMETO BE TRUE AND CORRECT. ALL <br />1140R�TTACNFOURLOPi[51 PROVISIOMSOFLAWSANDOFDINANCESGOVERNINGTHISTYPE <br />U� � I OFWORKWILLBECOMPLETEDWITNWHETHERSPECIFIEDHERE• <br />— IN OP NOT. THE GRANTING OF A PERMIT DOE;. NJT PRESUME TO <br />GIVE AUTHORITY TO VIOLATE Ofl CANCEL THE PROVISIONS OF <br />ANY OTHER STATE OR LOCAL LAW REGULATING :'ONSTRUCTION <br />OR THE PERFORMANCE OF CON�TR'JCTION. <br />SIGNATU/R "[�p�F CONIIIRCTOR OR /AU\INORI2E� PGENi DA7E <br />X{\�. � // _ / / �/ . �1 ti �_. � �. <br />�a <br />GAS FIRED A C <br />THIS PORTION TO BE COMPLETED BY BUILDING DEPT. PERSONNEL <br />nf.0 OV <br />AN[♦ <br />PlANS <br />SIDE GCTBACN �'LAN <br />VACANi SILC <br />❑I[S t]NO _ <br />MA% OCC. IO�D <br />❑UILOINO <br />PLIIMBIN� <br />MECH�NiG�L <br />OTMER <br />PENALTY <br />TOTAL <br />IMOER PLAR ChECNF[E <br />fEE NECEIPiNO <br />FEES V�LU�TION FEF <br />S <br />