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�ERMIT APPLICATI� <br />BUILDI�l�/MECHANICAL/PLUMBING/S1GN/SPRfNKLER/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 />q _/�D`1 —� Jr <br />(or new construction: Shotl PlaVsubtlivision Lot No._ (at�ach copy of long legal descnption) <br />PhonelE-mail <br />_Owner _Owner'sAgent �,Conlraclor _CoNractor'sAgent _Tenant(m�s�w�.��e��ror,eraimoso�io-�rir.00w�ermaowoninin�:o�«) <br />State Lic. # <br />I <br />NG PERMIT APPLICATION <br />Existing Use of Butlding <br />425-7 `. <br />�, . <br />�� �r- <br />PRICE OF WORK <br />Bus Lic. # <br />Proposed Use ot Building � t�as_ eiecinc_ v�nei_ � <br />Buildin9 type: � Singl_ Family _ Duplex _i ownhouse _ Multi-Family _ Commercial <br />Type of projecl' New Addi�ion _ Remode� _ Repair _ 7.1. __ Sign _Sprinkler _Demolilion_Change of Use <br />DESCRIPTIUNCFWORK(addtt�ona�spacepru�idedontheeack) �QEp�q� EXISn+`�G %�211//(�E (%%f}'�L— <br />• cS�RVIC.Q LUlTi�' N�% WF}Ti�L S�(Cf i'lll/�2 'T'tiE �'lT�- ryl�¢-1'E'z— Tb <br />"7�-i� f�tJf.tSE • <br />otProjecl _New_Addn _AlMration_Repair <br />Show Numbcr (qJ ol /ixtures <br />AfC _ nir hanrllinr. unitc <br />SY <br />Number of <br />ol Project: _New __Adtln _Alleration _Repair <br />ShowNumber(N)ol/ixtures _ <br />Medir.ai Gas <br />� � Othcr (�/L( <br />I heleby eeridy Ihal I l.uve reatl anG examined I�is appl�,calion:mJ tnow Ihe s0me lo Ue Ime an� correct. All piovislon; ol I�vrs and ordin.lnce; govCminq Ifu; lype ol work vn:l �e complicL <br />•,�.,Ap wpellier specifie� hercin or noi. The 9ranlinq ol a pe�m�l tlnes nol presume l0 9ive aul�only lo violq�¢ or cancel IAe provivon ol any of�er ,lale o� locnl larv �egulaling wnslruclinn <br />ihat I am aWhonzed Oy Ihe w�ner al IOi: proprtly lo peAorm I�r wo�k lor w�ic� �ppl:oition is matle antl I compty �•�il� Ihe Slate CoNraclors Law 79 27 RCW �nd 196 ]OOA'/JAC. <br />qll.S <br />Owncr A arizc enl Si9nat Uale (Revrsed 4i70I5; <br />