Laserfiche WebLink
' �� �-iPPLICATION FO`� ���,�„ <br />1 tMEwrym� CONSTRUCTION O. <br />GT'� OF <br />' everett PERMI�r <br />� BUILDING D[PARTMEN7 T� gE COMPLETED IN INK- PLEASE PRINT <br />1 259-8745 <br />� ❑ DEMOLITION ❑ CnMBINATION �BUILDING ❑ MECHANICAL ❑ PLUMBING l7 SIGN <br />� M�IL�DOBC55 GIfV ZIP PIIONE E'.Z Z <br />OWXER <br />NOn�THSil�E Cl�•4�Gli oF 6oJ .253� vi2l.i�/.'n cv�RFTr �8.��i �S:Z-�°3i- <br />. ANCNrtELTOFDE510nE� w��t�DORE55 Cirv 2iP PNONE <br />OENEA�LGLN1F�ClOR M�il �OU�C55 Cirv LiP P�IONE ��GENSE• <br />CyuRC,y S/� nE A S A6o✓r <br />AUIL ApUP[55 Gli! 21P PHONE UCENSE • <br />MEGN�NIf.L CONiRAC10R , <br />V W NB�NO LONI R�C10R <br />MMlAp0�L55 GtY IIP PIIDNC LICENSE• <br />CUSS OF WORM <br />❑ NEW ADDITION ❑ ALTERAiION ❑ REPIIIR ❑ DE!AULITION ❑ WOOOSTOVE/FRPL.INSERT <br />WLWTIOM O� �'NAK �CO51 OF M�iE1iI�L5 FLU9 L�BOAI <br />'✓ �'s av,o�� — <br />' • USEOFBUILDINO <br />� c�Nu�'C N <br />� /�/O�L DESCAiPT�OH O� �ROPEAIYt�SNOM'N BEIOW <br />I� V • �i'fw2C r�a C� <br />tot__e�oc �u � or <br />' � .C.� /7 �-�A' f1l.�c.k <br />, �1ar- � %�.t�w.t Of <br />; 'A/pOIEGT�UDRE55 <br />�: V .25.'l� Y-.2S3z Yi2GiN� <br />� vwwsiNa <br />NO. TYI'E OF FI%TUHE <br />t WATERCLOSCT TOILE <br />i BAIHTUB <br />❑ OUILDING RELOCATION <br />I HEREBY CERTIFY THAT I HAVE READ AND E%AMINED THIS AP� <br />PLICATION AND KNOW THE SAME TO BETRUEANOCORRECT. ALL <br />rouacocicsi pROVISION50FLAWSANDOFDINANCESGOVERNINGTHISTYPE <br />— `+�fi OFWORKWILLBECOMPLETEDWITHWHETHERSPECIFIEDHERE• <br />IN OR NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO <br />GIVE AUTHORITY TO VIOLATE OR CANCCL iHE PROVISIONS O� <br />ANY OTHER STATE OR LOCAL lAW REGULATING CONSTRUCTION <br />OR THE PERFORMANCE OF CONSTRUCTION. <br />SIONAiURE OF CONflIACiOR ON RVf110R�2ED AGENT DA1E <br />X �lX4..� �� /%/GZl�VLt�I- ' %'!J <br />APPIICANTSC1tV OUSWE9SLIC[NSE NO <br />S <br />AC <br />M <br />THIS PORTION TO BE COMPLETED BY BUILDING DEPT. PERSONNEL <br />N �- <br />� USE 20NE � <br />%� - J <br />TVPE OF COHST. <br />� � <br />; sizE or atqa �� <br />.� c°vv< <br />� FIFE SPRINKLERS RI <br />f <br />i <br />�PPUG�iiON�GC tiv <br />, � Y/ <br />� <br />, <br />, - <br />R[�R SEIB�CN <br />�: � �t <br />LOL�RE♦ <br />����b <br />OCCUP�NGYGHOUP <br />�� � <br />� <br />$IOE SEIB�G <br />,v,� <br />WC�NT SitE <br />❑VES C�10 <br />� <br />occ �o�o <br />Nr9� <br />AFPR fOIi15SU�NGEBY <br />L • c. . <br />NCHEGK UMOkH <br />8`7 � 80I 3 <br />FEE4 <br />BUIlDINO <br />PLUMBI.10 <br />MECRANICAL <br />OTMER <br />PENALTY <br />TOTAL <br />rEE (� I� <br />� <br />V�LU�TION <br />s '�'�� <br />:�E��<FE� ///'''��� <br />I1ECE�PiNO �lq� <br />� <br />fEE � <br />� <br />