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1�ERMIT APPLICATIO� <br />BUILDING/MECHANICALIPLUMBING/SIGN/SPRINKLER/"UEMOLITION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 Cedar St., Everett, WA 98201 425-257-8810 FAX 425-257-8857 www.everettwa.org � <br />a <br />r <br />') ��11�/'�+. /� i� �.a-/Fill Vf^ 1 � �ivv... <br />e <br />lor new conslroction: Short PlaUsubtlivision Lot No _(atlach copy ol long legal descripfion) <br />� <br />L/ Z 5� � 30 %7A2-1 wr <br />l�'+✓ K�� � / � <br />_OwnersAyent _CoNractor _CoNraclor'sAgent _Tenantlm�npro.�oo�ioueroiwn:omi�ommem.*erioaowon.ininesD°�a� <br />Lic. # <br />BUILDING PERiWiTl1PPLl�ATION <br />PRICE OF WORK <br />C��, Bus. Lic. # <br />Uoe of Building HEAT SOUP.CE: <br />d Use o( Building Gas Elec�ric_ Other__ <br />type-, _ Single Family _ Duplex _Townhouse _ Mufli-Family _ Commercial <br />aroject: New __ Addition _ Remodel __ Repair _ T.I. _ uign _Sprb�kler _Demolibon Change of Use <br />;IPTION OF WORK (addhonal space provided on fhe back): r n 5 L.,� '2_ <br />r� vw� c.� 1� �:I-cH,un � y�G.�^-�,.�e-�j, �1 r G� wt U�l Y, ..,�,� y�Pi'�^ e�,-�- <br />�'eraV�-� or v�L}� - r4�� �Ccdkl�)' �' ����� �h5,i��0�� <br />ot Projocl: _New _Addn _Altcration _Repair <br />Show Number (M) o! /ixfures <br />— A/f: – air handlina units <br />I <br />of Heads <br />TypenfProjecL• _New__Addn _Alteration_Repair <br />S(ww NumDer (p) ollixfures <br />Olher. <br />Other <br />Gas <br />� �� <br />I hereby cenAy �hul I have reaU . nd e•aminetl Ihis appUwUon an0 know Ine �ame to be bue anC cmie�� A�I piovis��.ns oi I�Hs and o�tlinances gove�m��g I�is lype ol woik wi] ba wmplied <br />vnlh wAelne� specAieA h=rein of nol. The granting ol a pe�md does nol presume l0 9ive :rvthonly to violale or can.cl Ine piorivon ol uny olher slute oi lowl law regulalin9 consimcUon <br />T�at I am authoriietl y ih rme t �his propeny to petlu�m I�r work for vi�ich upPLcation i, matl�<7I coir�ply with Ibe Slalo Conlraclws Law I B 2i RCW antl 29G2UOA W�C <br />�;. _ . �.rz/�� <br />_ �,� (Revised 4R015) <br />