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� <br />� <br />PER14111T APPLICATION <br />BUILDINGi�diECHANICALlPLUMBINGISIGN/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 />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM � '�I Z <br />PROPERTYTA%p P RMiT# <br />ADDRESS: o�%U , ao�.�� <br />;.�u,.�, l'r t� /CDt-r—r d1/1n. 1 IA 1�.. i <br />L lor new constmclion: Shotl <br />PLICANT�. _ Owner _ Owners Agenl _ <br />� � ���� �� <br />BUILDING PEliMIT APPLICATION <br />Ezisling Use of Building <br />No._ (altach copy ol long legal description) <br />1Zfii�i.�u <br />� <br />AgeM _TenenUmastororaoaieneralwnsamvwnmocwnvrmaowonc'inmespaco� <br />( QN'(}Q/.�� 8 I lic. # Cl. S <br />�'b }�,t(11 ��'uFi PhonelEmail l f'1 <br />CONTACT FO PERMIT <br />���� <br />PhonelE-mail – – <br />CONTRAC7 PRICE OF WORK _ <br />Proposed Use o( Building I "°'— <br />Building type: _ Single Family _ Duplex _Townhouse _ Multi-Family _ Commercial <br />Type of projecC _ New _ Addition _ Remodel _ Repair _ T.I. _ Sign _Sprinkler _Dem <br />DESCRIPTION OF WORK (add�tiana� space provided on rne back): <br />�N s,-�-t, ��,� �► o� Ty P� � K��-�+-� <br />MECHANICAL PERMIT APPLICATION <br />of Project: _New _Addn _Alteratlon _Repair <br />SPRINKLER <br />Gas <br />Number of <br />SYST <br />j COE Bus. Lic. # <br />� I� L�C <br />o��. <br />PLUMBING PERMIT APPLICATION <br />of ProJect: _New _Addn _Altcratlon _Rapalr <br />ShowNumbcrlbl o1/ixfures <br />se <br />Medical Gas <br />Other: <br />I AereOy cetlily that I hava �cad ana examined t�is app6caUon an7 know the same lo be W e antl cortec�. Ail provisians al laws and ortl�nances governin9 this lype ol work wi'I Ee campUcd <br />wAh whelner spenGcO hemin ar not. The granting ol a permil tloes nal prcsuma to give autnonly la violak or cancel the pmvision ol any m�er sla�o or lowl law regulating consWction <br />iTat I am aut�orizeE hy t�e owne� ol l�is properry to peAorm I�e work for which application Is maCe anC I wmpy wrth I�e State CoNratlors Law 7817 RCW antl 296200A WAC. <br />��� g 7 � 20 12 <br />Own lAutho ed Agent Signature Date <br />(Revised 6R072) <br />