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tN Er�rprNn <br />an or <br />everett <br />BUILDING DEPARTMENT <br />259•8745 <br />�-�1PPLICATIOId FO�t <br />CON�TRUCTION <br />PERMIT <br />TO 8E COMPLETED IN INK • PLEASE PRINT <br />❑ DEMOLITION ❑ COMBINATION O BUILDING ❑ f!AECHANICAL <br />❑ PLUMBING <br />rMONE <br />everelt <br />� <br />❑ SIGN <br />4EHER�L CONfP�C10R M�II n00N[55 Cltt :IP PHONE I.ICENSE • <br />MEGII�NIGLCONiRACtOq MAI��DOPESS GIiY ZIP PMONE �ICENSE� <br />PLUMBIN.CONfRACiOfl M�ILApORE53 CILV ZIP PIIONE LIGENSC• <br />❑ NEW ❑ ADDITION G ALTEFATION ❑ REPAIR ❑ DEMOLITIO;� �WOODSTOVE/FRPL.INSERT ❑ BUILDING RELCCATION <br />VnLUNiION OF <br />OESCfiIpE WORN <br />URINAI <br />VACUUM <br />USE ZONE <br />fYPE OF GONSI. <br />SIZE OF BLOG. <br />FIRE SPqINKL <br />AV PLIf,RIION �CC <br />LA90P� <br />OF <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS AP• <br />PLICATION AND KNOW THE SAME TO BETRUEAND CORRECT. ALL <br />PROVISIONS OF LAWSAND ORDINANCES GOVERNING THISTYPE <br />OF WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HERE• <br />IN OR NOT. THE GRANTING OF A PERMIT DOES NO7 PRESUME TO <br />GIVE AUTHORITY TO VIOLATE CR CANCEL THE PROVISIONS OF <br />ANY UTHER S7ATE OR LOCAL LAW REGULATING CONSTRUCTION <br />OR THE PERFORMANCE OF COIJSTRUC?ION. <br />SIQNATURE OF CONTRACT�p pq pUTHORIZED AGEN7 OATE <br />X /� . )/ _ _ � „ i _ /.. /,. <br />nre <br />GFS FIRED AC. <br />WALL <br />THIS PORTION TO BE COMPLETEL� BY BUILDING DEPT. PERSONNEL <br />LOT�REF <br />OCCUPANCYGflOUP <br />NO OF SIOPiES <br />7ED ❑ YES � <br />PUHS CNECNED BY <br />VACANT SITE <br />�YES ONO <br />MA%.00G LOAD <br />RPPR <br />BUIl01NG <br />PLUM9ING <br />MECHANICAI <br />OTHEP <br />PENALTY <br />TOTAL <br />FEES <br />FEE PELEIPtNO <br />VALUATION FEE <br />f <br />