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PERMII' APPLICATION <br />BUILDING/MECHANICALlPLUMBING/SIGN/SPRINKLER/DEMOLITION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 Cedar St., Everett, WA 98201 - 425-257-881D — FAX 425-257-88:�7 — www•everettwa.org <br />APPLICATIONS ARE ACCEPTE� FROM B AM TO 4 PM � oZD ��Z <br />� PROPERNTA7(q -� ^�y ��? <br />P IT k <br />ApiRy S5: � C ���v�. r� ���.�� �;a 4� ���� � Z �� '. GO�{(i � 7 CiU �d-1 /"I �l i!� <br />I <br />LEGAL for new wnstmction: Short PlaVsubdivision — <br />Lot Nc._ (altach copy ��f long legal description� <br />JWNER �T�..,.:l.��sr � roQ�r��cs <br />lddress 17i�C�V U:'i.� ��./p(/K'".v�. >'i4'��✓ <br />CONTRACTORL�`F-�r�•;C 1 ��uw�'1��� ���'�,'.= <br />4ddress (� �'�:.f.s �4-- �Z-�iY 5l 4-� ����ti� <br />iENANT BUSINESS NAME <br />�c.� �� �: � �'`� <br />BUILDING PERMIT APPLICATION <br />Exis.ing Use o( Building <br />8 I Lic. H <br />LJ �. S �-, <br />1 rv��,t, (�.. � 2�� z. <br />�"4i�t`j �i' �L <br />Phonel"matl �{LS-SZ7•�[zLZ <br />JRPERMIT�Y`� F,,tL•,t�*-�K-�S <br />�{Z'��tiZl�'lZl l G`�c_.,-����� <br />PRICE OF WORK � C-C-�— <br />HEAT SOURCE: <br />Proposed Use of Building --�- <br />Building type: Single Family _ Duplez _Townhouse _ Mulli-Famity 1C Gommercial <br />Type of project _ New _ Addilion � Remodcl _ Repair � T.I. _ Sion _Sprinkler _Oemoiition_Change of Use <br />DeSCliption of Wo; k(atldifional space provided on Ihe back/: <br />� you started working without a pertnit7 _YES k ND <br />MECHANlCAL PERMIT APPLICATION <br />of Project: _New_Addn ,_Alleration_Ropair <br />Other <br />PLUMBING PERMIT APPLICATION <br />of Project: _New_Addn _Altcration _Repair <br />Show Number /F'J o(lxtures <br />Medi�al Gas <br />Other: <br />'� Numbcr ol Heaos � <br />i hereby ceriify that I have read and exumined tni, applic riion and know ihe same to be hue and corcecL All pmvisions nf IaHs and ordinances goveming <br />tnis type of work vill be comp6ed vn�h wheLher speci(md h rein or not The c�ranting of a permit does not presume lo give a�'horiry to �iolate ¢ cance� <br />tne provision ot any othe�j tate or ioca! law regulaling con tmction or ihe pedormance of constmction. Tha: I am autnorzeC by :!m owne� ol ;n�,s oropr.�.y <br />In a^-dorm ine woi�ifor vyfiich ap i is made and I co Py� �vin the State Contraclors Law 18.27 RCW and 296.2�0 WAC <br />l /�� I �- '<L _,U�= <br />7Y7 / , C� � ' � <br />GL (Hevicatl 2/7011J <br />OwneAAuthorized Qgent Signawrc <br />�'� <br />( � i1.. c � <br />``!_ <br />