Laserfiche WebLink
� <br />� <br />PERMIT APPLICATION <br />BUILDING/MECHANICALIPLUMBINGISIGNISPRINKLERIDEMOLITION <br />CITY OF EVEREl7 PERMIT SERVICES <br />3200 Cedar St., Everett, WA 98201 425-257-8810 FAX 425-257-8857 vnvw.everettwa.org <br />D5 APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />AGDRESS: PflOPERTYTA%p P MIiC <br />.e� �,. a rm o.,ti r���.ra i174d'91-i- �/1 I LI I� �, D <br />lor new con;wction: Shon Plal/su�division Loi No._ (allac� copy of long legal descnD�lon) <br />y,� ��ni,x �# 2,95 ICily/Slate/Zi�9 �1�1 �1C.QC.,i� i n 2 l�/�) 3� <br />�T: Owre� �O�.mcYs/+9em _Conira:b: ConlraUor'sAgent Tenanl(mmip�e.-anamne�o!mn:.�iuommne�nuwao..onnmespuq <br />:TOR , S � L 8 I Lic. J! Q..� � I,"I I Cl7 COE Bus. Lic. a''rJ' I <br />1) � �- �'—r Q ��U �' PhonMEm2il ��Q a � " � <br />3USINESS NAME CONTACT FOR PERMIT �� r. j� /�I ',� <br />�-/ L`'�i <br />"'�j � f Tg Phcne�E+na�i 1„u�� � 1�` <br />NG PERMIT APPLICATION CONTRACT PHICE OF WORK `��U � C�_�_ <br />asling Use of Builtling �'K�'Y1l.LS� I <br />�opased Use o( Building �� x(11 9 C <br />iilding lype: _ Single Family _ Duplex _To�.vnhouse _ �1ulti�Famity � Ccmmerc�al <br />�pe of projecC _ Nevi AtldiGon Rzmodel _ Repair _ T.I. _ Slgn _Sprmkle <br />ESCRIPTION OF WORK (atld�fioral space prodded on fho back) : <br />MECHANICAL PERMIT APPLICATION <br />ol Pmject: _New_AOtln K Alleratian _Repair <br />Show Number (MJ of fiifwas <br />^7 � NC — air handling unils b c <br />I Forcetl av svs�ems <br />nooa <br />Other <br />� <br />PLUMBING PERMIT APPLICATION <br />olProjeel: _Hew_ndtln _Alleratmn_Repair <br />Show Number (A1 0l �rfures <br />h;;aler <br />Metlical Cas <br />Olher <br />" I <br />I IicreEy cenRy thal I �ave reJ� a�d ewmineE Ihis apG�T��'=^ �^� knoei �Pe same �o Ue INe an0 Ca!req. AA p+avi;ans al Uws anG orOnances 9ovemr a I��s type ol wntk wtl Ce compfeE <br />.MI� wnet�er specA20 �ere� or nol The g�antmg al a perm�l Coes not presume to qrve auNr.ry lo violate a+uincel lhe pwr¢io.i ol anyol�er sla!e or beil Uw mgvlaLnq :onstrucuon <br />Thal I am aul�ar¢e0 Cy i�e ovmer ol lnrs propury 10 pedo�m L�e wo•k for wh'mn ap0l.wuon rs ma0e an01 cOmply vnl� Ihe Slale Conlraclors Law 1827 RCW ana :96 ?OOn VL1C. <br />�� b�� '7-1�— �� `� <br />OwnedAuthorized Agent Slgnalure � Dale /Revisetl f✓1012i '� <br />