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'-APPLICATION FCIR <br />G E°"'""" CONSTRUCTION "e <br />everett PERMIT <br />TO BE COMPLETEU IN BLACK INK — PLEASE PRINT <br />BUILDING DEPT. <br />259•8745 ❑ COMBINATION ❑ BUILDING ❑ MECHANICAL ❑ PLUMBING ❑ SIGN <br />OWNEH / MI1IL�DUqE55 GITY ZIP P���NE <br />/(" y�� � �'1 �iG 1�- cL� �'�?cF �'vEC'E•T ( <br />.�/'IL�.:��J f.��-/� ��� � 1 ):' � �—(-?3 1L) <br />•NCZII�ECiOH0E510NER M11L100PE55 Clrv ZIF PIIUNC <br />� i il� ' 9 f n "'l�f / �"� C~, 7'i�f � i� O <br />C. L'l,_'!'t"_� / L I>>I� �_' L7 � � COLT �l ,EL G.�'f 7' �><.� 9, ZU/ �. �, � G� J? �— <br />GEN[R4LONiR�CiON • MM��pDRE55 �� CIfV plP Pn0�1[ L�LENSE• <br />i.r-••.�r'✓sl��•�� 5;,e�s �l���l�/ �,��,��. z�//l �u�l�/ �f���>y ���� �7�/��:�/,; <br />MELIUNiC� CONTIIACtOq MMI�O�RE S � GITY IIP PIIONE 1 �NSC� <br />i�0/7r�%n/3��'s /�°��L <br />PWMBINOCONIP�CIOq N�IL�OOHESS CIfV Z�^ v11JNF� IICCN[C• <br />CL�SS Of WORN <br />❑ NEW � ADDITION ❑ ALTERATION ❑ fiEPAIR ❑ DEMOLITION ❑ WOODSTOVE/FRPL.INSERT ❑ BUILDING RELOCATION <br />W W�fION Of WORN �COSi 01 MAfC fiI�LS PW 5 L�BOfn <br />f / ;5 ���� <br />ocsCtl�eE wonR <br />x.'/�AC/UILIr�/.'�:nl,>1�1��4T£I� S.�c <br />: Of BUIIDIHG ' ` �,� <br />`�'�'�i/[��� r %l�iLt./ ��G�c'✓�Urc��i <br />t <br />Q [SCfUI`IiONOFP00PC111v1,C�� WNOELOWOR�iI�GNFOUNCOPIES� <br />� ��4 � /`:/ � �J • <br />BATHTUB <br />DRAIN <br />I HEREBY CERTIFY TfiAT I HAVE READ AND EXAMINED THIS.4P• <br />PLICATIONAND KNOW THE SAME TO BE TRUEANDCORRECT. ALL <br />PROVISIONS OF LAWSAND ORDINANCESGOVERNINGTNIS TYPE <br />OF WORK WILL BE COMPLETED WITN WHETHER SPECIFIED HERE• <br />IN OR NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO <br />GIVE AUTHOflITY TO VIOLATE OR CANCEL THE PROV�SIONS OF <br />ANYOTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION <br />OR THE PERFORMANCE OF CONSTRUCTION, <br />SIONATUREOFCONTR�G�OPORRU1110RIZEUAG[NI DRIE <br />X .!'%C � f f,�als� �, ; �7-.� � <br />�PPLICANTSCIL OU9INESSIIGEN5EN0. <br />M <br />EA <br />THIS PORTION TO BE COMPLETED BY BUILDING DEPT. PERSONNEL <br />1110Nf SEfIIA( <br />20� <br />�5� Z�NE <br />�� <br />I1 PL OI COH <br />Y- N <br />SVt Uf OIbC <br />.IW�iONALG BV <br />�1� <br />V�CANi SItE <br />OYES GMQ <br />YG110UV NO.OFDWELL <br />1 � � � <br />f/1iE5 M�%.00M1Gt LOR <br />7 y`� <br />PIANS f,ll[CKEO BV <br />1-}-�e3/'Y1 <br />7T�AT i�i4T riv �?AG7 y �j �T <br />.`.H..O �O STD� lf/A� .�ZtG <br />FORISSU�NCEBY <br />�'� <br />�s <br />BUILUING <br />PLlIM01NG <br />MECIIANICAL <br />OTMER <br />PENAL7Y <br />TOT�L <br />IM9Efl PUN C�IECtl f EC <br />��J re[ . /'J^ m ri m �o <br />, _�� � <br />FEE4 VRLU�TION iEF <br />:l <br />qz <br />y�P� r�,E� .e,�. �� ✓�'�..,� I�G 117 <br />.as �> r.' G��l �� ��i3 aGi 1 <br />yi . • ., <br />