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� � <br />PERMIT APPLICATION <br />BUILDING/MECHANICAL/PLUMBING/SIGN/SPRINKLER/DEMOLITION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 Cedar St., Everett, WA 98201 425-257-8810 FAX 425-257-8857 www.everettwa.org <br />lor new constmcliorc. Short <br />; Sh�,r� �u, <br />l� <br />w �- <br />rnx n <br />No._ (altach copy ol long �egal descriptioiQ <br />5 ssv ic <br />��r�'} l..iA" <br />-U <br />ANT: Owner _OvmeisAgcnl Coniraelm ConlraUoi4Agen1 TCnanl�m�slp�o.�aaa�ei',erolc�nunnmmineanncrioCowoMimm�spa<e� <br />ACTOR /L(p (� r,•/� � State Lic. #J Gly �us Lic p 0 53(03`_ <br />l7S�S �/l�"S,f SG S.�l-r 'S�, lr o Poo���em��� �/a1S —7�v �� 3�v <br />f BUSINESS NAME CONTACT FOR PERMIT <br />PhonefE�mail <br />DING PERMIT APPLICATION CONTRACT PRICE OF WORK <br />Exisling Use ol Buildmg I-fEAT SO <br />Pmposed Use of Bwldmg Gas_ Electri� <br />Dwlding type� _ Single Family _ Duplex _Townhouse _ Mulli•Farnily _ Commercial <br />Type of projecf. New Addqion Remodel Repair _. T I. Sign __ Spnnkler _Demolition _ <br />OESCRIPTION OF WORK (adc�;:onal spacc p�a�ided on �nc �;ick) <br />MECHANICAL PERMIT APPLICATION <br />Typc af Projecl: _New _AAdn _Allcration _Repair <br />ShmvNumbcr(pl olhr(ures <br />- air liantllma imits <br />au <br />Otncr <br />Nurnbcr of Heads <br />ol Use <br />PLUMBING PERMIT APPLICATION <br />Type ol ProjecC _New �Addn _Altcralion _Repair <br />Show Numbcr (M) o/ tixmres <br />(wash <br />W85hCf <br />FAed�cal Gas <br />Olhcr; <br />ihciel»ccinlyl�rll�ave�ea:lantl..amme�lnisnpp'�r.;�i�n;�ntl�nowlhc�ometo�etmennticarccl NID�on;ionsoll,iw�an�orG�nance.govemingl�,lypeolwo�kvnl6ecomp5etl <br />w��� u�einrr SpenLeJ ��nein or nol T�c 9rantin9 0l a prrmi �oe: nm Lrr:��mr in 9:�r a�.�tnady m:��ia�c nr r.inn � ine pmms�,n o/ nny amcr slalc or bc.l law requlalin7 mniWCLan <br />ir�dl I am avmObreE �y the ownCr nt I�r. propeny to peilolm InC wurl. lpr vin�:P ap��¢.tlmn r m�tln an�f I cvnpl/ �.vAn In.. Sldlc fonba:�m :l nw 1B 17 RCW anE 79G ]OOA WAC <br />�� L i <br />� �a ���_" <br />� �%;�� <br />Own�dAu�horilcU Aqunt Signaturc Uaic lr:c��:�n a�a:,; <br />