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�� <br />everett <br />BUILDING DEPARTMENT <br />259•8745 <br />"�PPLICATION f0.�' <br />CONSTRUCTION <br />PERMIT <br />TO BE COMPLETED IN INK- PLEASE PRINT <br />d---.,...�..... r, rnuaiuer�oN <br />❑ BUILDIN6 ❑ MECHANICAL ❑ PLUMBING <br />ereretl <br />e <br />f�FII�3J <br />PLUMlIHOCOMTPeCIOR M�Il��0uE55 ��n' Z�P P��ONE IICENSE• <br />❑ NEW ❑ ADDITION ❑ ALTE�inTION ❑ REPPIR <br />v�� � uunr� ni WORN ifAlT Of M�iER��LS PLU! L�lOPo <br />pE8GR19fvVnn b <br />� V <br />U E lUIlO�Mq � ' <br />--�(/Y <br />LEOK OEBGA� �OM Of PERTYIS <br />�ot_e�oc�c.._or_ <br />� � v?i-i^ Z7 � /J/!. <br />""i�� �f i�7 <br />USE20NE <br />OEMOLITION ❑ WOODSTOVE/FRPL.INSERT ❑ DUILDING RELOCRiION <br />I HEREBY CERTIF� THAT I HAVE READ AND E%AMINED THIS AP- <br />PLICATION AND KNOW THE SAMETO BE TRUEAND CORRECT. ALL <br />rouncovies pROVISIONSOFLAWSANDOFDINANCESOOVFRNIN6THISTYPE <br />OF WORK WILI. BE COMPLETED WITH WHETHEN SPECIFIED HERE• <br />IN OR NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO <br />GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS QF <br />ANY OTHER STATE OR LOCAL LAW REG ULATING CON STRUC i ION <br />OR THE PERFO� �MANCE OF WNSTRUCTION. � <br />516NATU�AE OF CONTRIICTOP OR �UTHORIZEO AGENi O��E ���-C <br />X (/ F �/A� �9 ��'Jl � _12�%�%2-C�-� <br />OF <br />AIR <br />THIS PORTION TO BE COMPLETED BY BUILDING DEPT. PERSONNEL <br />R[�N SEIB�GN SIDE SE10�GN <br />✓L�N CNECh NUMBER PL�N LHECK IEE <br />FEE I nECEiPi NO. <br />�CC BY <br />�RE� V�G�Ni SitE <br />OYES ONO <br />CNELNEOBV <br />UNITS <br />BUIL�INO <br />PLUMBING <br />MECl/ANICRI <br />OTIIER <br />PENAI TY <br />f0T111 <br />FEES I V�LU�tION I FEE <br />S <br />