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� <br />� <br />PERMIT APPLICATION <br />BUILDING/�VIECHANICALIPLUMBINGISIGN/SPRINKLERIDEMOLITION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 Cedar St , Everetl, WA 98201 425-257-8810 FAX 425-257-8657 wvrw everettwa org <br />!/�.�7—�3 <br />ODRESS: . E�.GN S � <br />• 3zB t � <br />, !or new conslrucl�on Snoh PlaUsuDd�v�sion <br />o�`R�T�xp � �i,i i�311 <br />oc � 93 y o000 69 00 <br />Lot No _____ lattach c�Ny ol long Icgai tic;cr�p!�mp <br />R ROB�=:i 1' J(9�Ly PhonerE�mail �1L5 •ZGS - O rN ¢cJa-� 5n 6t Y a?c <br />S'28 E 6of�'-ff St Ev6c�s�' %SZa 3 cnrisiaie�?�p E✓F1�Ef wn 9F2c 3 <br />:ANT:�Owrcr ___O.vnr.r'sFycrl __Contracter ,_ Conlraclo�;�3en1 Tenan�;m.:i�,:.a.,,u^e�r+a,�.��inu.r�^�ao,�<i•oao.r,+�-^.+.c����•� <br />iAf.Tf]R %�iin/�y.5 �1S4TIn1� �n/i, $tdt0 L'C N NAao� N IOAG 7W Cdy �JS LiC b <br />0 <br />z <br />�'..�.0 ' �u� .. <br />Klc�; ScNi'1�pr Ar hA.�Y's ho9r�,�C� <br />vnorr[�ma i 3(0� - HZ,y � 09(o i� <br />BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK , S� 9`/. 9 j_ ___ <br />Faist n3 Use ol fl�ilyirg _s!!���L=_ � i��:Y. �5»"'`rWt--- h1FAT SOURCE <br />Proposed Use ol9udtl�ng_ __ ,____ Gas [iecluc __ Omer__ <br />Bwiding ty0e %� Singie Fam:ly _ Oupiex _iownhouse _ MuIU�Famdy _ Commc�c�al <br />Type ol pre;ect New Addil�on __ RemodM_ _Repav 7 1_ Sign _Spr�nkier __Demo;d�.on_ Change ol Use <br />DESCRIPTION OF WORK lavd t�cnal sn��=e p�ov�tletl o� mo bacw) <br />flo(� 1y15 Gr,vC tilio^9 �+E�F�a, ie .tiSw T,9NI:cEf.S t�a�c.i HraT.:: ,v.,•-7,.,Fo�J �vqr.lr'S fiR.Si�Wt.: <br />I�Js�2T. �NSGie� TAVRCtfS l.91�C H�ttr�C A.�v �inE/�G9e.> �•v5e�- <br />MECHANICAL PERMIT APPLICATION <br />Typc al Pra�acl: _Now ___Addn _Alloration _Ropav <br />S�ow Numbcr (�) ol firfures <br />NC - �R h30tlLnq UndS <br />Gas <br />hCalC� <br />�SUPPRESS <br />Number of Heads <br />PLUMBING PE�RMIT APPLICATION <br />Typo of Pro�oct: _New _ Apun �Alloralwn _Repair <br />Show NumberlM) o! /�rtures <br />I L8VdI0fy (W! <br />$hOwCf <br />H�tChC�� s�nk <br />D�shwasher <br />j Clathes was <br />.t—W,iicr hea��, <br />Si�1k (SeNlct <br />fiack0ow O�e <br />i ��— <br />pnnkinJ f ul <br />Floor drain <br />Grease Irap <br />� Rooldia�ns <br />Medical Gas <br />Olher <br />I OereoY �c��h ��al I nn.0 reatl a�f. e.nm.neA Ihis appi�wlicn anU Mnow ihe same lo Oe I�va en0 mnect AI� pwv� �onf ol lawf o�a o�d.na�cef goveminq Inif lypn ol woiM wA 0�� ra+�L�.��� <br />wnn w0e�ncr [Dec��c0 �rrem or na� tne q�a�lnrq ol a Oe�M Eoef �al C�esum� io qire eu�noMY �o vw�aie o� wncel Ine prcvrs�on ol a�Y o�ner stale m low� �an �equUUng �ynU �r�m'� <br />T�nt i am 0u'�o�rteC Ey Ine aan,n N i�is p�o0e�y lo pe0orm I�e wo�� �of wMc� apD'Kel�an Is miCe a�0 � mmpiY �'�� ��e Slale ConVaclo�s Law 1B i1 RC W a�a I96 700A 11/•G <br />,.� z } ti�� � i 3 <br />OwnedAuth rirod qonl5ignature Daie fRec�seJ3?0�71 <br />