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�ERMIT APPLICATIO� <br />BUI►_DINGIMECHANICALIPLUMBINGISIGNISPRINKLERIDEMOLITION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 Cedar St , Everett, WA 98201 425-257-8810 rAX 425-257-8857 v✓�•nv everettwa or <br />M I�o�-� <br />ADDRESS: /^Qh� <br />V �!/ <br />b� new consLUW�on� Short PlaUsubtliv�s <br />OWNER �.y✓y/�� <br />rax a <br />INo _ <br />3il �/ <br />� <br />(atlach �opy cf iong legal CcScnFlion/ <br />_QWOCiSAJC�I _COnYdC10� _CO�ItdCI0i5f\JE01 _T20dt'.I;�^.cctprcw�oaic.".crc'ccr.rn>c�PaowncrioGoroM1�o'.Pcsaou) <br />TOR nwn <br />BUILDING PERMIT ARPLICATION <br />C-xishng Use ol Bwldmg <br />Lic. # <br />�elE-ma�l <br />PRICE OF WORK <br />Propcsetl Use o` �u�ldmg L <br />6m�d�rg tyoe�. __ S�ng�e Family _ Duplez _Townhouse _ �dulli•Famdyx Commercial <br />Typc cf oro�ed Ne�v Adddion � Remodel Repair _ T I. _ S�gn _Sprinklei <br />D ESC RI PTION OF W ORK (addihonai space prov�ded on me back) : <br />MECHANICAI. PERMIT APPLICATION <br />olProjecl: _Aew�Addn _Alteration_Repair <br />Show Plu.�nbcr (H) o/ likfures <br />—� NC — air handlinq units <br />s <br />mt <br />� <br />4 <br />Bus L�t # <br />Othe <br />of Use <br />PLUMBING PERMIT APPLICATION <br />ol Project: _New _AAOn _At�eration _Repai� <br />Show Num6er (kl o/ IrxNres <br />Unnal <br />Rocf diains <br />Medical Gas <br />Olher. <br />i nere�y cen�ty Ihet i have reatl anC exammetl Ih�s app:¢auon anC lnow �ne same to be ima and correcl. All prov�sons af laws a�tl or0inences goveming this lype ol xrork vnn Ga comp�mn <br />wnh wnei�er specrfetl �eiein oi nol T�o grammg ol a pertn�t docs noi Orzsumo �0 9ive em�ority io violaie or cancel the provisron ol any other s!ala or rocal iaw regWnlinq wnsnv_ia, <br />T�et aumomea �y Ine o�.vner of Inis pro0eny lo peAortn Ihe work lor wh¢� appircaeon is ma7e anJ I eomprywil� I�e Slate Conbacto: s law t817 RC W an0 79E 200h WnG <br />� 7( �/l� <br />O nedAut Ori d genl 5ignature Date (Revised J�:O!7) <br />