Laserfiche WebLink
fM Enryrwn <br />urr a <br />everett <br />BUILDING DEPT. <br />259•8745 <br />i4PPLICATION FOk'� <br />CONSTRUCTION <br />PERMIT <br />TO BE COMPLETED �N BLACK INK— PLEASE PRINT <br />❑ COMBINATION �L.BUILDINO ❑ MECHANICAL ❑ PLUMBING ❑ SIGN <br /><�, <br />t elov c.-' <br />6ENEPAICONTR�CTON MAIL�OOHE55 CITY ZIP PHONE LICENSE• <br />MECH�NIC�LCONTMGTO�7 MAI�AOOHE`4 P�tt 21P FHONE IICENSE• <br />PLUMBINO CONTMCTOP MAIL ADDFESS CITY 21P PHONE ��CENSE • <br />Cl�SS OF WONN <br />❑ NEW �.ADDITION ❑ ALTERATION ❑ REPAIR ❑ DEMOLITION ❑ WOODSTOVE/FRPL.INSERT ❑ BUILDING RELOCATION <br />V�lyf 110.N O�F WO�H�N �COST OF /M{AIEA��lS� rP W S UBOR1 /� Q= <br />Clr 1/-1�._- ( nJ � i!.�� _ E'� ..( � C�6 <br />�iT�CH <br />i�- ?,�l r_'7 — <br />JRV <br />r� <br />nve <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS AP• <br />PLICATION AND KNO W TH E SAM': TO BE TRUE AND CORFECT. ALL <br />PROVISIONSOF LAWSAND ORDINANCES GOVERNINGTHISTYPE <br />OF WORK WILL BE COMPLETED WITH WHETHERSPECIFIED HERE- <br />IN OR NOT. THE GRANTING OFA PERMIT DOES NOT PRESUME TO <br />GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OK <br />ANY OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION <br />Ofi l'HE PERFORMANCE OF CONSTRUCTION. <br />SIGNATIIRE � F CONiHACTOR QR AUTHOflIZED AGENT OATE <br />X � / c_ �7�iv�Ctc� �!� <br />�oo�.iC�NTS CITY BUSINE55 LICENSE NO. � <br />THIS PORTION TO BE COMPLETED BY BUILDING DEPT. PERSONNEL <br />NEAR <br />X-� S N �1. <br />tYPE Of CONST. OGLUPANCY GROUP <br />�'�n/ rZ- 3 <br />SILE Oi 6L00 NO OF SlOfil[5 <br />/!�' r�G� l�GK N A <br />FIRE SPRINhLEPS REQUIRED l] VES AV <br />APPIICAt10N �CC. BY PUNS CNECNED BY <br />�,� ��� <br />% <br />VACANT SIIE <br />OYE3 jtNO <br />NO.OFOWEL <br />N, r9 • <br />FOP 19511�NCE BY <br />� .c. <br />��S <br />FEES <br />BUILOING <br />PLUMBING <br />MECHANICAL <br />OTHEfl <br />PENALTY <br />T0TI1L <br />�ee 7 f. Q�— <br />� <br />V�LU�iIDN <br />� <br />