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PERNlIT APPLICATION <br />BU�LDING/MECHaNICALlPLUMBING/SIGN/SPRINKLER/DEMOLITION <br />�IT'� �F FVERETT PERMIT SERVICES <br />3200 Cedar St., Everett, Wi 9820 i 425-257-8810 FAX 425-257-8857 www.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM i O 4 PM %�-� 6' I Z <br />ADDRESS: PROPERTYTAHH PERt T# <br />�-� I�v,�� � n F� �� i Gv /-1 Y I U`1- - <br />for new construction: Shorl Plal/subdivision Loi No._ (at�ach copy ol long !zgal description) <br />G �,v W A �( <br />_Owner _OwneYsAgen� �Con�raclar _Con�ractofsAgenl _,Tenant(m�s�pmhae�ien�roiwnsemimmmaowr.�rmaowo�tmmospace) <br />; M rlt: K s�-u sca, <br />�� LI.E !1� Lks � <br />h�IT�IVY=55 ��Aro�t� nc,tir <br />BUILDING PERMIT APPLICATION <br />Fr.isting Use of Building <br />Picposed Usz of Buildir <br />L& I Lia #/1�1 r4/�'K 5' i� �% � - COE Bus. Lic. Y <br />�4�j j �{ PhonelEmail `�{,ZS� -/�i.5 - �8-� � <br />CONTACT FOR PERMIT <br />PhonelEmail ���5� %G�S -l���i��_ <br />CONTRACT PRICE OF WORK ��POO U � <br />ng type: _ Single Family _ Duplex _Townhouse _ Mulfi-Family <br />of oroiect __ New _ Addition _ Remodel ,_ Repair _ T.L _ <br />�TIONOFWORK(atlditionalspacoprovidedonthe6ack): ^ <br />LCti�-� i3 �/�( C, �,V e� � rc �o VZ � � <br />MECHANICAL PERMIT APPLICATION <br />of ProJoct: _New_Addn _Altoratlon _RoFalr <br />Show Number (p) o/ �ixtures <br />air <br />of <br />PLUMBING PERMIT APPLICt�TION <br />of ProJecl: _New_Addn _Allorotlon _Ropair <br />shaw Num6erlHl o/lixtures <br />Other: <br />Clher; <br />I h^� ":y ce�ify Ih.l I havo read and examined ihis appPcation and krow the samo U bo t'�c ond mrmct. All pro�isions o� i�ws and ordinances goveming this type olwork vnll be rompPetl <br />w��th whel�er spec�fed lerein or ncl. The 9ranting ol a pertnit does nat presuc�e to gi�e aulhonty to vlolote or ancel t�o provision of any ot�er state o� lo:al law re3ula;ing canswclion <br />That I om auNon d 6y I�e o�fner ol Ihis �ropetly lo pertortn Ihe work forwMch appliw�ion is ma]e antl I mmply with the Stale Co.�iraqo:s La�.v 1827 RCNJ an7 25G 200A V1nC. <br />�� �/z� (iz <br />Owncr/�rized Agont Signatvro Date (Revisetl 6/2G72) <br />