Laserfiche WebLink
,�1PPLICATIUN F4.1 <br />'""E".,°'.," CO N STR U CTI O N <br />r,r.r oF <br />everett i PERMIT <br />TO HE COMPLETED IN BIACK INK— PLEASE PRINT <br />BUILDING DEPT. <br />259•8745 ❑ COMBINATION � BUILDIN6 ❑ MECHANICAL LI NLIiMBING ❑ SIGN <br />�ir.•n n M�il nc. o.., ' f d cin iir rr�oHE g�� <br />IJ�C.-. r eN2�s X.�W:-L s; _� L, CADJ RD. A-LCZ �E�/FJtE77 9Pu>' 35'3-7Y7L 02 <br />nqL�uifCIOBDCS�ON[B M6Gi0eRE55 CItY ZIP PIIONE <br />SI��`1G � <br />f.tl! �'1 fC•1�P�G�OR AI::L�UURE53 CIfV ZIP PIIONE UGENSE • <br />S��'�%���: <br />�.�fG��:l'.:ALG9N�R�CiOF M�IL�UGHESS CIfY ZIP PIIONE LIC[NSE• <br />�'ICIAOINCCON�R�C�OR M�IL�DOBE55 CIIY ZIF P110NE LIGENS[• <br />Stit'�r rvvun <br />� NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ DEMOLITION ❑ WOODS70VE/FRPL.INSERT ❑ BUILOING RELOCnTION_ <br />vn� vn urni or wonK im ;�'-' �••n nu�s rws ueom <br />�N—i�-�c� 70� e�(LC�j. �O <br />oe sc��m � wonK <br />NEc�/ u,�.lSi?-ve:trc� <br />usr or nunmrm FV THAT I HAVE READ AND EXAMINED THIS AP- <br />FhM � <br />MI � <br />Ise�c.�.e�} TN � <br />S�iiW��T To �►`� <br />I WAIER HEAIEIi __ <br />URINAL <br />ORINNINO FO'�HiAIN <br />FLOOR ORAIN <br />VACUUM BREAM.ERS <br />ROOF DRA1115-RA�M <br />SINK SE�iViCE-BAR, <br />U5t <br />S <br />OR <br />T • <br />I HEREBY CERTI <br />PLICATION AND KNOW THE SAME TO BE TRUEANDCORRECT. ALL <br />runcoviEs PROVISIONSOFLAWSANOORDINANCESGOVERNINGTHISTVPE <br />� �, g�yb OFWORKWILLBECOMPLETEDWITHWHETHERSPECIF�EDHERE- <br />IN OR NOT. THE GRANTING OF A PERMII DOES NOT PRESUME TO, <br />GIVE AUTHONITY TO VIOLATE OR CANCEL THE PROVISION$ OF <br />K ANYOTHERSTATEORLOCALLAWREGULATINGCONSTRUCTION <br />OR THE PERFOFMANCE OF CONSTRUCTION. <br />_� .. _.�� SIGNATUPE OF CONTRPCTOB OR RUiHOR12ED POENT UAiE <br />BOILERS—H.P�CA. <br />M <br />M <br />C �tw�t _ 1 '7 3 _ 5'S.. <br />THIS PORTION TO BE COMPLETED BY BUILDING DEPT. PERSONNEL <br />f1C�N$CIO�C1t SIUESF.� �LN PLANCM[f,VNJMOER fi�NC��ECNfEF. <br />�P .i �E� neCnrir�o <br />�w; 'Zr FT '7 1z.�7 �3 /y3)� 3�� �-- �d� �3 -- <br />LOI��EO �.eCANi51TE FEE4 V�WIITIOH fEE <br />94CS ONO I <br />•CC Br <br />�r:,>>�-� <br />HQ C i �WElUNO bN115 <br />1 <br />� <br />fON ISSII�NCE <br />B11110!NG <br />VlUMf11NU <br />t1ECN\NIC4L <br />OTH[R <br />i ENPLTY <br />IOTAL <br />7 0, �,d�m <br />�7�/.tG?U� �sOT <br />2s �T• L-ao�� <br />t�Et�.�/P`Cic�+c.l !�'� <br />n� '[ l.lv 'A!_Dt. . <br />343 00 <br />2�t- � c <br />__� ��Z UO <br />Y� GSt�-F�Fr <br />'TM� b��/�C'� <br />1�a� 'Fa'oo�- <br />� <br />N <br />DJ <br />H '~+f <br />�� <br />My <br />d � <br />� <br />�z <br />� <br />�~ <br />m <br />o� <br />� H <br />N <br />� � <br />. � <br />� <br />� <br />y <br />C�� <br />Hn <br />�7 <br />