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PERMIT APPLICATION <br />BUILDING/MECHANICAL/PLUMBING/SIGlV/SPRINKLER/DEMOLITION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 Cedar St., Everett, WA 98201 425-257-�810 FAX 425-257-8857 www.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />PROPERTYT 9xk PERMIT# � <br />ADDRESs' _.._ _._T ..... ,.., �rrr� 7RnSlxo�3ohlUo 1; I�I�I�-�- �'C� <br />LEGAL for new conslmclion: Shotl PIaL'subdivision _Lol Na_ (attach copy ol long legal descriplion) <br />OWNER <br />Phone/6mail <br />Owner _Owner'sAgent�Conlractor _, Conimcloi'sAgeni _Tenanitm�sic«.:�eaieue�etco�ce�ii�ommeo�,.�e�i000��v,k�,�is�oo�<el <br />&ILic.# <br />T �i <br />N '� � i7jlX��-1�- <br />BUILDING PERMIT APPLICATION <br />Exisling Use of Building <br />Proposed Use of Buiidir <br />k02 <br />PhonN[mail -zrj �- 37] �ZT-Z t <br />R PERMIT M�z�� ��,�E <br />'� S3 t3 7 7-Z 27 2.�,.-H a e�.fr: o+-t : �� <br />PRICE OF WORK 2 O S� <br />HEAT SOURCE: <br />type: _ Single Family _ Duplex _Townhouse _ Mui�i-Family _ Commercial <br />�rnin�P New Addition Remodel __ _ Repair _ T.L _ Siqn _Sprinkle. <br />CRIPTION OF WORK /aAdilional spac^ ryovided on Ihc b�iek) : <br />MECHANICAL PERMIT APPLICATION <br />Typc of Project: _New _Addn _.4lteration _Repair <br />Gas <br />PLUMBING PERMIT APPLICATION <br />ol ProjeeC __New _Addn _Altemtion _Repair <br />Show Numbcr (d) o/fixfures <br />Medical Gas <br />Olher: <br />Number of Heads ""'c'. <br />I I.�.mby cetlily Ihal I have reod and oeamined Ihis nppl�catlon anA knmv ihe snme to Ge Ime nnA wned. All pmvisions ol laws and ordinanccs goveming Ihls ype of work will ta mmpllcA <br />:.dh v:helher speciGed herein or not. Tho graniing ol a pemiit does not presume l0 9ive:wihonry lu viclale ar cancul Ihe pmvisron ol any o•�her sl:tle or local law regulating coiulmc;:on <br />1 i�.n I am a Ihodzed by �hc owner of Ihls property to pedomi Iho work for wiikh applwmion 3 madn and I r.ompy v.nh me S1N^_ Contraclms Law 7827 RC1V and 256200A'ilAC. <br />�� �o�� <br />OwnclAuhdiz dAgentSlgnaWrc Dale (ReviseclG/20t21 <br />