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����i19� �►P��.9G�`���� <br />�UIL.DINCIMECHAI�ICAL./Pl_UMBING/SIGN/SPRINK�ER/D�lIIIO�,ITION <br />CITY OF EVERETT P�RMIT SERVICES <br />3200 Cedar St., Everett, WA 98201 425-257-8810 FAX 425-257-8857 wv✓w.evereriwa.org � <br />/D -�7 `-/S <br />ADDRE55: PROPERttTAXN rcnnni n <br />�0 4 F��..�.:,.,J� S� Ev-�r�c�F k'42a3 � ��i�0_-or� 9 <br />\L for newconshuclion: Short PlaUsubdivislon Lol Ido._ (atlach copy of long legal descrlption) <br />ERCGiVi� �Ol.i(�4C�r PhonrJE-mail G2f2�k �Z�9 <br />ss G� O nj F�.r �..�.1 u r S'� CitylState2ip d t}l �`C 7'F w f� "1 8 Z Q � <br />.�CANT:,_Owner _OwnersAgent _CoMractar _ConVadofsAgent _Tenanlln�sipmrnaorou�raunsem��mmew,.��rioaowonmmespr�� <br />fRACTOR /f U� �-e- c�� C � k�- State Lic. # Ii V L L t I r B� I�S�o City Bus. Lfc. k <br />ssZii�L �oll��K• $. l�ubury, W!� Q84O� Phonelemall zt33�7 aTZ4 ^ <br />ILDING PERMIT APPLICATION coNTrtncr rRice oF woRK _�� � <br />ing Use of Bui�ding � H�� �^ �' k( HEAT SC <br />osed Use of Buildin ��� t� Gas_ EIecV <br />ing type: Single Famiiy � D plex _Townhouse _ Mufli-Family _ Commercial <br />of project: _ ew _Addition _ Remodel _ Repair _ T.I. _ Sign _Sprinkler _Demolition_ <br />CRIPTION OF WORK (adddional space provlded on the bacN) : �7 4 ��' �� � ti �.� q( � q�� e�, <br />j-v,' Sv (w ���S <br />otProJecL• _New_Addn __/Uterdtfon_Repair <br />Show Number (x) af fixtures <br />Change of Use <br />pti '{ L.A f o 0 <br />o(Pro)ect: �New_Addn _AlteraGon_Repalr <br />Other. <br />Number of Heads v"'r'. � <br />I hereby �edtylhat I have iead and evamined IhL• app!Icaiion and know I�e same �o he Irue and carrecL All provislons ol law. aad ordnances governing Ihis type of xork wtl be complied <br />wilh whelher;peciLed herein or not. The giasGng of a pemtil doc, not presume l0 9Ne aNhoriry lo violate or canccl the pmvision of any other slate or local law regula:ing constmclion <br />Thal I am aulhoracd by dm oHner f Ihis pinpe�ry fo pertorm th� work forwhich app6wVon Is made and I compty �r.IMho Sl�m ConVa�lors Law 1027 RCW and 29a70oA WAC. <br />. �oj9 �S_ <br />Owner uthorized Agent Sf nature <br />17ate (Revlsed 42075) <br />