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� <br />PERMIT APPLICATION <br />BUILDING!MECHANICALIPLUMBING/SIGN/SPRINKLERIDEM�LITION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 Cedar SL, Everett, WA 98201 425-257-8810 FAX 425-257-8857 www.evereltwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />zs <br />rnx a <br />I I Stdoo n <br />lor new consirudion�. Shert PlaVsubdivision Lot No.`_ _(attach copy o� long Iegai descripbon) <br />i'S-�JOF1(-. Dl��l <br />(�125 �Z9�M Sr c� <br />2910 <br />_Ovme� _OvmersAgent _Contractor _Contractor'sAgenf __ Tenantn�.ve�:M•.,�>i•^�%'�^�:•,������n.ow,.�i�e,..on��+n,...�acn1 <br />ONTRACTOR �f�L� <br />T��`I No.��.S <br />BUILDING PERMlT APPLICATION <br />L&ILic.N <br />P,:421oa�U.�A NI�LS <br />ie�E-mail c4zS.31'1-8D1� <br />VTRACT PRICE OF WORK <br />Existing Use af Bwlding Na.�t. SP.wr-1 HEAT SOURCE: <br />Proposed Use ol Building_N4�1.. SP.�-j Gas__ Eiectnc _ <br />Building type: _ Single Famiry _ Dupiex _Townhouse _ Multi-Family ,� Commercial <br />TypeofprojecC New Addition Remodel Repair�(T.I. Sign_Sprinkler_Demolition_Change <br />DESCRIPTION OF W ORK (additiona� space provided on tne back) : <br />Other <br />ol Use <br />E�L�.Clil7—ib r�4L'TIC�i OF C-�Vrc1ZED OELIc'T� lr-#(y.�P�- ly 1/-L'if�'L1CX1 �.L�• <br />I 5 8' ►� add rti rn� <br />MECHANICAL PERMIT APPLICATION <br />of Projecl: _New _Addn _Alteration _Repair <br />Shaw Numbcr /pJ ol /ixtures <br />AIC - air handlina units <br />ClOthes <br />SUPPRESSION <br />IVumber of <br />PLUMBING PEFtMIT APPLICATION <br />ol Project: _New _Addn _Alteration _Repair <br />Show Numberlk) ol �rtwes <br />Othec <br />Olher: <br />hC3t8f <br />Gas <br />I I�ereOy cenry Nat I nave reae and eaammed this appl�wGen and know Ihr same to De Irue and cortecl. All D�ovisions ot laws and oM�wnces govem:ng U�rs �Pe ol wor� r�il be compdea <br />x•,Ih wfiellier speci.'Wn nerein cr no1. The gra�::ng ol a pCrtfit aoes not Cfesume to 6�ve aNhonry to valate or wncellCe provi5ion elany ol�er s1a1e or local law regu�at�ng conslrucuen <br />That I am outhonred Ey Inc owncr olih��s pmpeM �o pedorm Ihe worA lor wh!c� app6wSon rs niatle and I wmD�i �^��� ��e State Conlractors Ww 18 27 RCW anC 24G200A WAC. <br />�L.(�-(S2� 9 � 2 . � � <br />OwnedAuUiorized Agent Signaturc �ale <br />��y <br />(Rcv�sed 6'20f7) <br />