Laserfiche WebLink
��:PPLICATION FO.�� <br />p ��""" CONCTRUCTION <br />everett PERMIT <br />BUILDING DEPARTMENT <br />259•8745 TO BE COMPLETED IN INK • PLEASE PRINT <br />everen <br />e <br />D DEMOLITION O COMBINATION ❑ BJILDIN6 ❑ MECHANICAL ❑ PLUMBIN6 ❑ gl(iH <br />OWNER M�IL�D�RE55 CILY ZIP PNONE <br />7. A TlCwso,� 3�,�y l�1 E'�v+� oaE Ev,� I-t tr aS9 -� 3� y <br />OEHERALGOHiReGip11 MMI��OPE55 CIiY ZIP PMONE ItCEN9E• <br />�jl.o.v's �in�wE2 131Ib b'��iA�. N�p fiM1G..��io✓ qyL�3 �59•))b� ALA,�SN��„ <br />MECNIINIC4CANTP�CIOq M�IL��ORES9 CITY Z�P m�nuo ..��.'��_ <br />RUMlINACONfMCTON MML �OpRE53 O!" ZIP MIOHE IICEHSE • <br />a�ee or won� J <br />❑ NEW ❑ AOOITION ❑ ALTEHATION IF7 REPAtR C7 DEMOLITION ❑ ��pUDSTOVE/FRPL.INSERT ❑ BUILDINO RELOC�TION <br />V� WliTinH or vmnk �cner nr uuoow c e� ��� �....e. <br />OU <br />�oFG <br />�� ! G�4._ S <br />oG � 1 0� .�.+ <br />! <br />i <br />Er�3-T�L <br />fELOW qq1TT1CM FOUR <br />_ � J.✓ CCcQ. <br />� � �c cz.e�e <br />3�a.`� (,t)e�-w�c��.A, <br />I HEREBY CERTIFV THAT I HAVE READ AND EXAMINED THIS AP- <br />PLICATION AND KNOW THE SAME TOBETRUEANDCORRECi. ALl <br />PROVISIONS OF LAW3AND ORDINANCE300VERNINO THISTYPE <br />OF WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HERE• <br />IN Ofi NOT. THE GRANTIN(3 OF A PERMIT DOES NOT PF.ESUME i0 <br />GIVE AUTHORITV TO VIOLATE OR CANCEL THE PROVISIONS OF' <br />ANYOT'�ER STATE OR LOCAL LAW REGULATING CONSTRUCTION <br />OR THE PEfiFORMANCE OF CONSTRUCTION. <br />SION�IURE OF CONTP�CTpq OR �UiNORIZEU �GENT D�TE <br />X <br />RIR <br />THIS PORTION TO BE COMPLETED BY BUILDING DEPT. PERSONNEL <br />f'— B � <br />