Laserfiche WebLink
IM Eq�prwn <br />�a <br />everett <br />BUILDING DEPARTMENT <br />259•8745 <br />�<�':PPLICATION FO..� <br />CONSTRUCTION <br />PERMIT <br />TO BE COMPLETED IN INK- PLEASE PRINT <br />Q DEMOUTION ❑ COMBINATION ❑ BUILDING ❑ MEC!�ANICAL O PLUMBING ❑ SIGN <br />nw��w u cv GI1Y lIP PHONE <br />� �IL^ �iL�.�`.c�F' �.— i <br />_ !`• ' H� � --� �� ,�t-�.T. 5 �•. � c: �� <.s . e _ <br />iENEMLCONtqACfOR M�IUUURE55 Cltt ZIP PNONE UCENSE• <br />�Y�'"�'c C�' �c' NA/ C � 9.� /`7� <br />�EGMI1NIGdWNiR11(fOq MAIL�DpHE55 GIIY ZIP PNONE �ICF.HSE• <br />`LUMlINOCONfP�G10N MAILAOORE54 ptV ZIP PIIONE LICENSE• <br />❑ NEW ❑ A�DITION ❑ ALTEFATION ❑ REPAIF � DEMOLIiION ❑ WOODSTOVE/FRPL.INSERT ❑@UIL�ING RELOCATION <br />'�LU�i1pM Of WORN ICO{T Of M�TERIIL9 OLU9 L�bOPI <br />iE�CRilE WORK <br />�� � I J )S � �/ <br />�\ .nC�c'e' /�c/� /C`I � � A/ J J'� Jr �/\��'G�/a r'.L <br />i!E OF �UILDiNG -� <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS AP• <br />PLICAtIONAND KNOW THE SAMETO BE THUEAND CORRECT. ALL <br />EO�I�O�E`t�CRIPiIONDiGpOPERIY�BMOWNBELOWON�tt1CN�OtIpCOVIF6� pqOV1310N80FLAW8qNDORDINANCE500VERNINOTHISTVPE <br />ola��e�oc r�nr J���� �'� �<<`%'•�T OFWORKWILIBECOMPLETEDWITHWHETHERSPECIFIEDHERE• <br />IN OR NOT. THE GRANTINOOF A PERMIT DOES NOT PRESUME TO <br />' `� GIVE AUTHORITY TO VIOIATE OR CANCEL THE PROVISIONS OF <br />/,//vi5��.� A ANYOTHERSTATEORLOCALLAWREGULATINGCONSTRUCTION <br />ORrTHE PERFORMANCE OF CONSTRUCTION. � <br />� 510�{1NNEOFCONiR�CTONORAUTNORIZEUAGEN7 D�TE�—�,_`Y 7 <br />\ ' � � �j <br />X � �, ='�l�l�:-_-�-�-� <br />AOIECT�ODHE39 • APPLIC�HTSCIfYBU51NE55liLEN5EH0. <br />n i <br />CONSf <br />eioa <br />P. <br />6 <br />OF <br />THIS PORTION TO BE COMPLETED BY BUILDING DEPT. PERSONNEL <br />NE�RuE1BACN SIOESEiB�GK PL�NCNECKNUMBER ` ' PI�NCNFCN <br />fEE IREL[iF <br />sr <br />�AE� WCAni51iE <br />DYES pN0 <br />�UPANCYGROVP NO.OF�WFI <br />rnex. occ. iwo <br />BI�IL�ING <br />PLUMBINp <br />MECNqNICRL <br />OTIIER <br />PENALTY <br />iOiAL <br />FEES � V�LIIATION <br />S <br />NO <br />FEE <br />