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s <br />PERMIT APPLICATION <br />BUILDINGIMECHANICAL/PLUMBING/SIGN/SPRINKLER/DEMOLITION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 Cedar St., Everett, WA 98201 425-257-8810 FAX 425-257-8857 www.everettwa.org <br />SiTE ADDRESS: % ,�O �� K PROPEP3Y TAX I PE�t01IT 0J <br />GL�YLN <br />LEGAL for new construction SnortPlailsubdivsan Lot NO latlaCh copy of long legal description) <br />OWNER 9+1-4d- 9S (C'IOAJST' Pnone/E.mad eFZS -33y _ r 3 99 <br />Address S%9-% 07rV 41A— NE kly/State/Zip M^%2-eSy'&4C , G!/A 9-?Z70 I <br />INT:_Owsel _Owtefs Agent/ Contractor _ContraCtor's Ageol <br />1Cienanl tcau•.: a�qr eercr ctcemer; nomnc v.+rrto ao,brm:�fpx[•i <br />TOR as//✓.0e ntn <br />J Y'L M10 �+..c� Znb State Lic.17 +vP%EZ Ze. City Bus La: u aU�098 <br />/'7�w '4".CAL / �2r-/+-Z'ZU "' 94f'223Pnone,Emad 360-yo 3 <br />BUSINESS NAME CONTACT FOR PERMIT Kam!•-+ +7i aljyNSav -t.�+�"S+-rt <br />Pnone/E+nail 2-S-0S-14T9 ,,-veepie,+we <br />IING PERMIT APPLICATION CONTRACT PRICE OF WORK <br />king Use of Building ncr t avum` ` <br />osed Use of Building Gas Etectnc Other <br />ling type _ Single Family Duplex _Townhouse _ Mulli-Family —Commercial <br />of project- New Addition Remodel Repair T.I. Sign Sprinkler Demolilion_Change of Use <br />iCRIPTIONOFWORK (additional space pmwdedonftback) FrRc Seer-ttccJL C %*7 <br />/ vS7-4cc CM •c n-P�aPOsr ) <br />7ti ti NrPA /3 i�Ad <br />MECHANICAL PERMIT APPLICATION I I PLU <br />of project: _New _Addn _Alteration _Repair <br />Show Number (p) of fixtures <br />A/C — au haodhnq units <br />Heat <br />/SUP <br />IT APPLICA <br />Type of Project _New _Addn _Alteration _Rnpair <br />Show Number (0) of fixtures <br />Other <br />Other <br />washer <br />Gas <br />I hrreby Certify that I have read and e.a mined this appication and know the same to be hire amt correct AN provisions of laws and crenances governing this type of work MR be camp <br />win wrlether specified heroin of hat. The granting of a permit does not presume to give authority to vroUle V cancel the proviscn of any other state or local law reguli conseudwn <br />Thal lal l a�,uhe owner of Ih eperry to perform Me work for which applications made and I edmpfy win the State Compactors Law 18 27 RCW and 295200A WAC I <br />.+ 4 9/Revised 42015) <br />Owner/Authorized Agent Signature C.ee <br />