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PERMIT APPLICATION <br />BUiLDING/MECNANICALIPLUMBING/SIGNlSPRfNKLERIDEMOLITION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 Cedar St., Everett, WA 98201 425-257-8810 FAX 425-257-8857 www.everettwa.org <br />r'I_„_��. <br />ADDR <br />TAX N <br />for new consimclion: Short PlaVsubdivision Lot No.._ (altach copy ol lony 1=�a1 description) <br />ER lC���� / U <br />a <br />�� ,�/� �� N A � /, . <br />- OU5 <br />PPLICANT:_Owner _Owner'sAgen� _,Con�raclor _ContractorsAgent _Tenant��,�sipm��eoaiec�rc�cansemaommeowr�rioc:,�:o:x��i���p�c�� <br />cTOR J/vK� IUG N h"�� ''�`� <br />ao�7 N�^, i3a `''�, S!' � <br />� ���� � � u S <br />BUILDIWG PERMIT APPLICATION <br />Stale Lic. � <br />4 �`jU �1�' f Fhone/Email <br />CONTACT FOR PERMIT 'ro � <br />Phone/E-mail �1 �J �� � � <br />CONTRACT PRICE OF WORK � <br />Use of Building -'< F 1�� �� <br />d Use of Building <br />type: _ Single Family _ Duplex _Townhouse _ Mulli-Famdy <br />Type of projecC New _ Atltlition _ rcemoaei _ nepau <br />DESCRIPTION OF WORK (additional space provided on the bace) : <br />yZ�,e�=-�� � <br />MECHANICAL PERMIT APPLICATION <br />of PraJocl: _Nnw _ Addn _Altorelion _Ftopair <br />Show �lumber (#) o/ /ixtures <br />/ <br />air <br />of Heads <br />Cily Bus. Lic. # <br />�� �� 7��J �� � �� <br />%(��� '}bM�f <br />fc..o-� wfort, •�a�.. <br />EATSOURCE: <br />Electric_ Olher <br />ition Chanqe of Use <br />PLUMBING PERMIT APPLICATICIN <br />o} ProJect: _New_Addn _Alturetlon _ftopalr <br />Show Number!#) o/fixtures <br />i Medical Gas <br />� Olher. <br />; Othe[ <br />n <br />I h:reby cenJy I�at I havo read and examinetl Ihis application and kno�,v lhe same lo be lrue nnd torrect. All provisions ol la.vs ontl orCinances goveming Ihls ry�pe of work vnli be compiled <br />�a�u'i v;nelher spe<ifed herein or nol. T�e granlin9 of a permil does nol presuma l0 9ive authority ta violate or cancel tAe provision of any other stale cr lowl law re9ulating consWction <br />That I am aWhonzetl by t�e owner ol Inis pmperty to peticrm t�e work for w�ich appLcation is matle antl I comply wtl� tha State CONrac�ors Law 182.' RCW antl 296.200A WAC. `� <br />�)In/� �=/2 � <br />��// /J ��'A � � � � <br />< �F J / <br />OwnndAuthonzedAgentSignaturo b Date (Revised3/2073) <br />