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10/20/2015 14:06 4254855609 PRIhJTC�RE #2818 P.001/001 <br />� � <br />PERM�`T APPLICATION <br />�UILDING/MECHANICAL/PLUMBING/SIGN/SPRlN�CLER/DEMOLITIOhI <br />CITY OF �/ERETT PEi�MIT SERVICES <br />3200 Cedar St., EvErett, WA 98201 426-25i-88'ED FAX 425�257-8857 www.everetfi.wa_org <br />IWDR�SS: <br />Een TAx � <br />EGAL for new construction: Short. Plat/supdivi5i0n Lot No. (attach copy ot long legal description) <br />iWNER I11 i,1� I� :ll ,�.11U 1f l� I 1'� Phone/E-mail ��'��,'! 1(„� (� ')�U l3� <br />�(�� � t5� 1(�,�P, S r ����,S�t�,�,P �'V��'�'�- , v��A W��?.C3 <br />_ _ ,� . <br />_ Qwner „ Owners Agent � Contractor _ Contractors ilgenl � T9ft2nt (muel prov�ao a wttor of mnaent kom tne owner ro ao work in db <br />NTRACTOR <br />\� <br />1� <br />BUiLDIN6 PERMIT aPP��CAYt�N <br />Lic. # <br />none/�malt � � V�j) Z�2 <br />_..��. . � <br />� P�RMiT � <br />ti��Yti% SG,VV�� <br />PRICE OF WaRK <br />�xisting lJse of Building _ __ � <br />Proposed Use of Building _ _ _ , <br />Building rype; � Single Family _ Duplex „�Townhouse _ Multi-Family _ Commercial <br />Type of projectd � New Addition _ Remodel _ Repair T.I, Si�n _Spnnkle <br />DESCRIPTION OF WORK (addltional space providee on the back) : <br />Z��� G� �,�i 5 V�-� Qi✓ 7�x �� <br />MECHANICAL PERM�T ApPL! <br />of Proj�ct: _New_Addn �Alteration _Repair <br />Show Numbe� of tTxtures <br />A/C — air ftandiina units <br />Gas <br />SPRINKLER / <br />s <br />Bus. Lic. # <br />of Use <br />PLUMBING PERIYIIY' APPLICATION <br />of ProJect: _lJew_Addrt ,� . Aitsration �,Repa[r <br />Toilet <br />drain <br />Other: <br />Gas <br />f nareDy certiTy t�at i Rave rea0 anC examineq f��s appii�s�ion and Iv�ow [�e same to he true antl camed, Ali provis;ons of lawe anC ordlnancee 8ovaming ihlg rype aiwork w�l6e mmpi <br />wlt� wAet�ar specfftee nerein or nat. Trie granung oP a pe�p aoea no[ presu me tn give authority to violat� or pncal tAa pmvislon ol any other e4ate or locai taw regulaUng aonstmdion <br />I am autttor�e0 p7( th ownar of Ihis p�nperly w pe�fortn t�e work (or wAitl� applicaUon is ma0e and I compry wlm iRe Sfata ConUadors �aw i 629 RCW an8 298200A WAC. <br />�� � tu 1tio tia I� <br />wner/Authorized Agent gnatur� Date (Revised 4/2015) <br />