Laserfiche WebLink
tOeErerprean `'�-.PPLICATION FO�.�' <br />°��°F CONSTRUCTION <br />everett PERMIT <br />BUILDING DEPARTMENT <br />259-8745 TO BE COMPLETED IN INK- PLEASE PRINT <br />❑ DEMOLITION ❑ COMBINATION ❑ BUILDING �MECHANICAL ❑ PLUMBING <br />owr�en Mni� nomiess <br />GIiY ZIP PIIONE <br />�� 7 I. � i3cv�yy-/7;SeC'.s'••C <br />rc <br />evereH <br />� <br />❑ SIGN <br />—17r_.t�__ %��7 �,- o :fv � � c�r-af•p Yr EyYre�l 95��: a.5"r G; %?� <br />c Y� o oe5 ._ ,,,,..__ V i ���. rm rrron[ <br />eErv[n�tto�nnne�an raniuDuncss cnv zir r��oN[ uctHse. <br />�nccrur�ic�icornnnc�oq Mu�eomicss arr ziv r�wHc uceNs�: <br />PLOMBiNOCONiNFGtOR M�I��0011E55 QTV 21P PIIONE LICENSE• <br />❑ NEW ❑ AOUIT�ON ❑ ALTE7ATION ❑ REPAIfi ❑ OEMOLITION 17L WGODSTOVEiFRPL.INSERT ❑ BUIIDING NELOCATION <br />wWetiou or wORe �cost o� me�tniM.s n�us L�Bo�U <br />WOIiR <br />95[ <br />io�_ <br />u3o <br />WAIER <br />I HEREBY CER7IFV THAT 1 HAVE READ A�lD EXAAIINED TIiIS AP- <br />PLICATION AND KNOW TI1E SAM� TO BE Tf1UEANDCOIiRECT. ALL <br />on�nnc��ro�mcories� pqOVI510NSOFLAWSANDORDINANCESGOVERNINGiHISTVPE <br />OF WORK WILL BE COMPLETED WITN WIiE7HER SPECIFIED HERE• <br />IN OR NOT. iHE GPANTING OF A PERMIT DOES NOT PRESUME TO <br />GIVE AUThIORITY TO VIOLATE OR CANCE� THE PROVISIONS OF <br />ANY OTHER ST�TE OF LOCAL l�W REGULATING CONSTRUCTION <br />OR THE PE(iFORMAMCE OF CONSTRUCTION. <br />SIGNAIUREOFCONiRACtONOfiAUi110fiR[Or1GENI pA1E <br />-- �� �, e '� Y .. , ... . <br />� �ccHsc un <br />EA <br />ORVERS <br />---' � ' 1 I IOTAI.FEE f� <br />THIS PORTION TO BE COMPLETED BY BUILDING DEPT. PERSONNEL <br />tHONISEIpnCN fIG115[�04CN $IOESE1pPGK PLANGb[GNlIUMDEII C�pNCII�[NfF.E <br />ICE O[LEIPI NO <br />U5C20NE LOfAR[n VACANlSII[ — <br />❑YES IlNO F[ES VRLUATIOH FEE <br />�1'�EO�f.ONtil OCCUP�NCYGOOIIP uOn[nwm�rvr.uurtc <br />moc <br />nrnucnunr+ <br />P14r15 <br />5 �MA% <br />1'ONISSV�NGEBY <br />BUILOINO 5 <br />PLUMOING <br />MGCH4NICAL <br />on�en <br />nENnLiv <br />TOTAI. <br />� ' . <br />� <br />J <br />