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�._ APPLICATION FJR ��� <br />IMErNp/M� CONSTRUCTION 0 <br />pn or <br />everett PERMIT <br />BUILDING DEPARTMEN7 TO BE COMPLETED IN INK- PLEASE PRINT <br />259-8745 <br />O DEMOLITION ❑ COMBINATION ❑ BUILDINO ❑ MECHANICAL ❑ PLUMBINO ❑ SION <br />an ziv o��oH[ � <br />M�ILADORE59 • r-' <br />�in slma� s'-T-�'cK�� ��Us •�n��cc,.us. c:dEu.rrr ')�•1.c�:� 3.�S--S�9 <br />v o e <br />OE P�LGON�R�CiOR M�IL�OOPE45 � `••• I a�"" )l. <br />�.0 �3l�lRT 4c� <.a,.,�- �v7oG� 4�T p.�c S� Ll�. �r:.Lo 35) 61+L •z �. i'J <br />� M�iL �ODNE99 CITY Z P FNONE l CENSE <br />MECMIINIUL CONiR�CTOR <br />PLUMlMOGONtR1G10R MGIL�DDaE39 GItY IIP VnONE IILENSE• <br />:L�SS OF W ORK <br />❑ NEW � A�DITION I� ALTER�TION ❑ REPAIR ❑ DEMOLITION ❑ WOODSTOVE/FFPL.INSEtiT BUIlDINO RELOCATION <br />V�U�TION O� W�AN �COS10i M�1ERI�L9 PLUS L�BOPI <br />a-; `-'t' � � . . <br />pE5GRI8E WORn � r �... • ,�f E�. fG. '� L J T t„i <br />A Cl J? J,�'� 'Z C. >.: I I� [I�ui� r" n i�[ �; �- ,T-�C U C'T� _ <br />use or eunon+a 1 HEREBY CERTIFV THAT I HAVE READ AND EXAMINED THIS AP• <br />�� �.,5�. i t t JV ; C<' PLICATION AND KNOW THE SAMETO BE TRUEANDCORRECT. ALL <br />AND ORDINANCES OOVEFNINa THIS TVPE <br />LEOAl0E5CRiP110NOFVROPEPIv� Owhnew������������^^�-� <br />,�_ _. LLc.�aGTa� Al� <br />�o,1�a�o��o. `.� > r.� ur r��- <br />- i� �,J Lv'� � ��) <br />�r � � {' c� .I .i c� � �. f�"F � -- � wti <br />,�,L. -,��� �.s N �.�s z�� F r i� � <br />/^ �V �� �-, . �, it or 7i-� J�'`'j <br />/ _ .J ' C` ._ . wl . <br />2 :i :J %� -- y'A•) �,,,�- Q .L <br />SKE <br />. ^ <br />r'ROVISIONS OF LAW S <br />OF WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HERE• <br />IN OR NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO, <br />OIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF <br />ANY OTHER STATE OR LOCAL LAW REGUTATING CONSTRUCTION <br />OR THE PERF/03jMANCE GF CONSTRUCTION. <br />� SIONRTURE O C ATRRCTOR OA AUTNORIZED RGENT DR7E <br />X lZL_���-iL1Lr_ <br />C�NT! CItY EUDMES9 UCENJE NO <br />i/ v 3 � -- <br />P. <br />T.I <br />M <br />THIS PORTION TO BE COMPLETED BY BUILDING DEPT. PERSONNEL <br />P CMECM <br />RE�RSEi9�LK SIDESEiW PUNGNECRNUMBER � <br />�. � l �1 � � "i�_ �l � y _ ffE / ,.-7 >�., � �Ec� <br />�S <br />�v- <br />rcnour <br />_ .�� <br />j � , � s� <br />BY <br />V�C�Ni jlfE <br />pvES �NO <br />NO.Oi DWEL <br />� <br />APPR FOR <br />� <br />UNIiS <br />G <br />BUILDINO <br />PLUMBINO <br />MECNRNIC4L <br />OTIIER <br />PENRLiV <br />TOT11l <br />l <br />FEES <br />J <br />V�LU�TION <br />� �����A�_ <br />;�1' <br />