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�ME~ro�»� �CONSTRUCTION <br />CIM1 OF <br />everett PERMIT <br />BUILDING DEPARTMENT <br />259-8745 TO BE COMPL�7'ED IN INK• PLEASE PRINT <br />everen <br />e <br />❑ DEMOLITION ❑ COMBINATION y�i3UILDING ❑ MECHANICAL ❑ PLUMBING ❑ SIGN <br />UN'i��A , MA4�DORE55 CIfY zIP PNOHE <br />!V� <br />M11L <br />21P <br />� <br />MI,b1ANiU�pONIP�C101� M�IL�OOf1E55 CIiY r,P PnONE LICLN51. <br />�WMB�N.CONIN�LIOR M0.i��00NE55 LI�V 2iP PupNk liLlNtil. <br />❑ NEW KY �DDITION ❑ AITERATION ❑ REPAIR ❑ DEMOLITION ❑ WOODSTOVE/FRPL.INSERT ❑ BUILDING RELOCAIION <br />vu u.nuH ro won. icosr or Mn����uis r�us ueoni _ <br />usi nr nun niwr. <br />io�_ <br />z6o/ <br />DRINNING <br />�Ibl lUNI <br />R- s <br />IYi'f �u LqNtit� / <br />� ^IV <br />�,�JI ar mn,: <br />� I HEREBY CERTIFY THAT I HAVE READ AND E%AMINED TIiIS AP� <br />PLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL <br />PROPERIYISUOWNOCLOWOR�il1LNFOURCOPIE51 PHOVISIONSOFLAWSANDORDINANCESGOVERNINGTHISTVPE <br />_a� �� OFWORKWILLBECOMPLETEDWITHWHETHERSPECIFIEDHERE• <br />IN OR NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO <br />GIVE AUTHORITY TO VIOLATE OR CAi'CEL THE PROVISIONS OF <br />ANY OTHER STATE OR LOCAL LAW REGU�ATWG CONSTRUCTION <br />OR THE PERFORMANCE ^F CONSTRUCTION. <br />SIGNRTVREOFCONTPACTOf10RAUINOR12EpAGENi 041[ <br />4-l1- 8 <br />NO <br />THIS PORTION TO BE COMPLETED BY BUILDING DEPT. PERSONNEL <br />hIn1�ONe�:r pr <br />�''� . �b� . <br />nten sciencn <br />��/ <br />LOl Alif A <br />�o.oao Sf� <br />� �� <br />r�u or s'�anies <br />VL�45U1lLFCI <br />JF� <br />� <br />V�CANISpE <br />OYES YHO <br />UNII$ <br />� <br />ePl`R. fOP ISSU�NC[ UY <br />L. c. <br />PIRN GNECN NUMBER <br />s6 i ��3�� <br />FEES <br />�UIl01NG <br />PWMBING <br />MECIIRNICRL <br />OTNEP <br />PENaLTY <br />TOT�I <br />�EE � C� ,�«���, �a �G <br />; 3 -7� � a <br />V1lU4TIDN fEE , <br />Y� <br />IlJ <br />�9ic�� <br />