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N <br />N <br />PERMIT APPLICATION <br />• BUILDING/MECHANICALIPLUMBINGISIGN/SPRINKLERIDEMOLITION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 Cedar St., Everett, WA 98201 425-257-8810 FAX 425-257-8857 www.everettwa.org <br />l�-6�--/3 <br />SITEADDRESS: _ _ _ � � � _ PROP�RTVTAXa � ^��^^ ^^^ PE�tMIi,# "� f,�F <br />7 ! 11 <br />lor new construction: Short PlaVsubdivision Lol No._ (allach copy ollong legal description) <br />PhunelE-mail <br />_Owner _OwnersAgent ,�CoO��dt10� _Conl�atior'SAgenl _TBOBM�mmipmneoalanero�wnserummmoownc�w0oworkinmospace) <br />ING PERMIT APPLICATION <br />� State Lic. # U Y�Z 1�C7 67 � City Bus. Lic. <br />/� �/.��-"/p�,>� PhonelEmail � Gi� 7� (O <br />CONTACT FOR PERMIT ���� J �L� �. <br />Phone/E�mail �-�'Z �% �S IPKvL <br />CONTRACT PRICE OP WORt: � .CYJi C� <br />ng Use of Building <br />�sed Use of Building - � <br />ng �ype (�...Single Family _ Duplex _Townhouse _ Multi-Family _ Commercial <br />o( projecf. New Addition _ Remodel _ Repair _ T.I. _ Sign _Sprinkleri <br />CRIPTIONOFWORKIaddGonalspacepro•ndedonfho0ackj: � <br />�sTA-i[., A— N-�.c.�/ C�c.7-i�r� 1-��,-r vi�'�-P, <br />MECHANICAL PERMIT APPLICATION <br />ol Pro�otl: _New _Addn �CAlleratlon _Repair <br />Show Numbef (M) ol lirfures <br />A/C - air handling unils <br />/ <br />HEAT SOURCE: <br />PLUMBING PERMIT APPLICATION <br />of ProJect: _New _Addn _Al�eralion _Repair <br />Show Num6rr fa) o/lixtures <br />r <br />drain <br />Other <br />Gas <br />NumberofHeads I v���a�. <br />I hereby certAy Ihnl 1 hnvu read anJ eeamined Ihi, app��cation and know Ihe 50mo lo Ee Ilue Bnd colletlJJl pmvisions ol �aw: nnd ord�,nances governing Ilns lypa ol worM vnll UC complietl <br />vnln vihelher speuGee Imwin or nol ine 9eanbng ol a peimil aoe, nol presume to yrve aVpority lo violnle or wncel Ihe pmvision ol any oll�er slalU or local law regulnlinq consi�u<tion <br />T�ul 1 nm aulhmnea Oy Ine oaner ol 1�i5 propCtly lo perlorm Om work bf v�hich appliWGon 15 ma0e antl I comply wAh I�a Sl:��e Conlractors Law 18 ?] RC W antl 296 i00A WAC <br />' -�- - - 11 r i3 <br />OwnedP�1 iodzedAgo��. IgnaWre Date (Revised"J?07J) <br />