Laserfiche WebLink
�ERMIT APPLICATIO� <br />BUILDINGIMECHANICAL/PLUMBINGISIGNlSPRINKLERlDEMOLITION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 Cedar St., Everett, WA 982U7 425-257-8810 FAX 425-257-8857 wvnv.everetlwa.org <br />�u,({ w� <br />OO6 <br />a <br />. lor new conslmction�. Short PIaU5u0tlrvision Lol No._ (altach copy of long legal descnplwn) <br />R �6 ( � ���/-�� PhonelGmail � 2rj /> I I p D SG�i� 7 G •i <br />`L Zj,� � S� S C GlylSiateiZ�p LV'2f� W 1 Zv � <br />:ANT:_Cv:ner __O:mer'sA9em _Contrac'ar _Comraetor'sAgenl _Tenantlm":;c:c.�oaa�e�ier�:mn:��;r•�minec.r.�r�oao..o��,�:n�:pcce� <br />._......�.�.._ Tn u n � � �� __ us. Lic. N <br />PhonelEmad <br />CONTACT FOR PtHMI I c_ 6� h; <br />�.(- ? / .x+ <br />C'i` `OlY1�ii�e✓ � � lY Phcrc/E�ma.l y�-/ /�71� D� <br />BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK �_� <br />Existing Use of Buiiding HEAT SOURI <br />Proposed Use of Building cas_ Eiennc_ <br />Bwldmg type: _ Single Family _ Ouplex _Townhouse _ Dlulti-Family _ Commercial <br />Type of proj?ct: _ New _ Adddion _ Remodel _ Repau __ T.I. _ Sign _Sprinkler _Demolit�on_Cha <br />DESCRIPTIONOFWORK(aCC�'ionalspaceprov�dedonmebacw): � � ' ' � ' � • <br />1�1�Q' � � S 1 � / V O{� � � i�.� �c'�'1 �U6�P a Se c Voui <br />� �y S-F c� S�c�ew5 <br />olProject: _New_Atldn _1111cration_Repair <br />Show Num6cr (N) of Iixfures <br />A/C — air handling umis <br />NKLER <br />of Heads <br />y <br />ot Use <br />pe of Pwject: _New_Addn _Alteration _Repair <br />Show Nurttbcr /N) of lixtures <br />Rool drains <br />Medical Gas <br />Other <br />Other <br />1 hweGy cerldy I�ai I have reaE and erammc0 ihls applicalion ur,d knoa I�e same to Oe ime an� mnecl. All piovrslons ol laws anC orC�nances govem�ng Inis ippe o� woik w:u oe compeed <br />vnt� wAei�er speaGetl �erem or noL The 9raNing ol a pe�md does nol presume lo g�ve aulnonty io violate or cancel ��e pwvision ol any oi�er siaie or lawi law regula!ing conslmct:on <br />T�al I am aulhonzeC by the owner oi I�is propeny to pe�orm Ne woik lor v�M1:ch appli�ation is matle an� I comply w9h t�e Slale CoMracto�s Law 1 B 27 RCW antl 296 200A WAC <br />G.� � /5/2 � ��, <br />OwncrlAuthonzed Agent SiynaWrc Date � (Revised aR075J <br />�lz <br />