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� • <br />PERMIT APPLICATION <br />BUILDINGIMECHANICALlPLUMBING/SIGNISPRINKLER/DEMOLITION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 Cedar SL, Everett, WA 98201 425-257-8810 FAX 425-257-8857 www.everetiv✓a org <br />A <br />L lor rGv consl�uchon� Shon <br />0 <br />r/vc u <br />No.___ (atlach capy al lorg iegal tlescnpbon) <br />mail � <br />S� <br />_ICANT:_Ovmer _OwnefsAgen; Conlractor Com�aetor'sngerl _Tenanti���..,i��a.�c,,.,m�•�:oico,:��•:voT��^.,o.:�n,co.o��-�e�::w_.�i <br />TRACTOR /�'T UC,� ����^�"� h��i'y Stalc Lic a Mocn ( f�+'��b � J i� Cdy �us Lic. q �$ 3�o � S <br />ss i%SIS `-/IS`Si' SG Seu,( �:n�e�. L✓�� �t�z�U P o c�Fina �}�% �,, eow. <br />I �ci.�� � Mu:.� �1�..-.% v. <br />P�onelF�mad <br />BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK <br />[xisting Use of Bwltling <br />Proposed Use oi Dw�ding � �+� <br />Butltl:ng type: _ S'�ngte F;mdy _ Dup�ex _To�vnh0use _ MultrPamdy _ Commercial <br />Type of pro�ec! New Addi6o� Remodel _ Repair T I. _ Sign �Spnnkler __ [ <br />DESCRIPTION OF WORK ;addn�n. � spacnpro��:dcd on mc bacx) <br />MECHANICAL PERMIT APPLICATION <br />ot Pro�ecC _New _Add _ _Altc�atlon _Pepair <br />SOo�v Numbcr (N1 0/ /ixtures <br />air <br />NKLER/S <br />Number o� Heads <br />o( Use <br />PLUMBING PERMIT APPLICATION <br />iype ol Projoc�� _New _Addn _Alloration _Repair <br />S�ow NumhcrlNl ollizWres <br />BaBNub <br />smk <br />Smk (ser <br />8ackflow <br />Floor drain <br />Grease tra, <br />Mctl�cal Gas <br />Olher <br />Otner <br />I�emOv�nAyl�atlhavereaanntlexammrCl�isappi�o�tiananEknowl0a;amntoECWenndwnecl Allpio.�son.c!Iaw50nEordman:esgoaeminglhislypealwoMx�ilCe.:omp'.cd <br />�rM xTeiber spca(.ca herein or not l�e 9iunhng oi a permil0oes not presume lo givo auinemy m v�c:a'.e oi uncel!^e provis'o� ol any c.�cr aate er ioc�i ia:i m,n:'ai ^9 xrsP.:a cn <br />l�al I am aU�entetl oy IOc ownc� oi ��is piapMty io V�rtorm t�e work for wTiet� apphni��on is maCo e•] i wmp:� �. �.n t.�u Sta'e C: rtracir} W e� 1 P? I HCU' and :55 : CO a V.'aC <br />���''-e- I 2 -�-2 �! �1 <br />OwnedAuthodzed Agont Signaturo Date !i:evaed 3�Ct: 1 <br />