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� <br />n <br />u <br />PERMIT APPLICATION <br />BUILDINGIMECHANICALfPLUMBING/SIGNISPRINKLERIDEMOLITION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 Cedar St., Everett, WA 98201 425-257-8810 FAX 425-257-8857 v,nrnv.everet�vfa org <br />ADDRESS: <br />rnx a <br />:SC� 51 Y��['e�'c l ft �/C �/ vuGTt w�ai — <br />LEGAL for ne�:� consimctmn S�+ort PlaVsuhdivision Lot No <br />R <br />(atiach copY ol iang iegai eescnpiwn) <br />�lZ�ri�� <br />� r� '/ <br />_Cv/fRt _O�vpEl'SA(�Cn( _COn�tde�Of _COnhdCtOf5A9ff11 _TC�dnl(nvstpcaJudtenerelcon:enl�:onmuvnr.v'oCoworkmmospacr) <br />7'l <br />UILDING PERMIT APPLICATION <br />e State Lic #/' T+M h! <br />� <br />S'W� �� PnonelEma�l oi� <br />CONTACT FOR ERMIT <br />�(�ly��- �OW.IK'i� <br />Phone�E�ma�l G:1JL IL` <br />CONTRACT PRICE OF WORK <br />Exisimg Use of Bwlding {..—_ <br />I <br />Proposed Use of Bu�laing_ L-- <br />Bu�ld�ng rype _ Sing!e Family _ Ouplex _Tov:nhouse _ t�4ulli�Family _ Commerc�al <br />Type of projed Mev� Adddion _ Remodel ___ Repav _ T L__ Sign __ Sprmkle� <br />DESCRIPTION OF WORK (aedd�onai soace mc•��aad on;ne oackl- <br />Re - roo � <br />MECHANICAL PERMIT APPLICATION <br />of Projecl: _Ne�.v_Addn _Allcration _Repair <br />Shaw Num6cr (u) ollixfures <br />— air handlinq units <br />air <br />BUS �IG %: <br />t�✓5 <br />CJC•L-�� <br />PLUMBING PERMIT APPLICATION <br />TypeafPwject: _New_Adnn _Al(cration_Repair <br />Shaw NumEcrlNl oll�x���es <br />Flaar drain <br />Med;cal Gas <br />Olher <br />I �ereCy cerbty Nal I have �ead ane eram�neC Ihis appl;cation and hnoe� I�e same lo be Ime and co�. AlIO�o��sion5 0l laws anE orCinanCesgoveming i��is Ipp2 olwoik wil �e mmpl�ed <br />�ntn oTeiher speULe� nere:n or no1 i�,e 9ranling o� a Fem.i does nol presume lo gae aut�.ady lo vioial_ or cancel Ine pwvisioe o( any o'�er slale or ictal larv �e9ulaf�g censlmclion <br />ihal I am avi�oiizetl�c owner ol iNs O�ope�y to Detlorm ihe �sork lo� w�ic� appi.ca�ion I5 made anU I mmply •:u�h �Re Siale Ccntractors Law 10 2I RC\7 ana I96 20DA N'AC. <br />� (Revised 3/2013) <br />