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PERMlT APPLICi4TION <br />BUILDINGIME:CFiANIC�LIPLUMBING/SIGN/SPRINKLERIDEMO! ITION <br />CITY OF EVERETT PERMI i SERVICES <br />3200 Cedar St., Everett, WA 98201 425-257-8810 FAX ^25-257-8857 www.everethva.org <br />�z �2 --I 3 <br />. for new consiructic�: ShoA <br />R T-�.,� <br />TAX p <br />Nu._ (allach copy ollong Icgal description) � <br />a <br />I� <br />i�Owner ,_OwnersAgen� _Conlnclor _CONraclorsAgr.nt _TenaN(musiv���oa:m;cruirensen�trommo:wner.oaowoM�nt�o.space� <br />Lic. # <br />BUILD�NG PERMIT API'LICATION CONTRACT PRICE OF WORK <br />f_xisting Use of Ouilding <br />Praposed Use of f3uilding �� <br />Building type: � Single Fami'ry _ Duplex _Townhouse _ Multi-Family _ Commercial <br />Type of projecf New Addition Remodel Repair _ T.I. _ Sign _Sprinkler� [ <br />DESCRIPTION OF WORK (adm�iona� spaco provided on tho back) : <br />�- �'e�I�-C�i� <br />MECHANICAL PERMIT APPLICATION <br />of Projoct: _Now _Addn _Altoration _Ropalr <br />SNow Nwnbcr(N) ol /ixfures <br />NC — air handling units <br />Boilcr <br />/ Sl1PPRESS <br />Number of Heads <br />• - •�� <br />T SOU <br />8us. Lic. # <br />of Use <br />PLUMBING PERM�T APPIIGATION <br />o1ProJocl: _Now_Addn _Altoration_Ropair <br />Show NumbeNtt) o/ l7xturcs <br />� Clofhes washer <br />Other. <br />Olher. <br />Gas <br />I I�err.by cenAy t�al I have reaa and eaamined Ihia epp!ication anU knrnv tha same lo �e Ime and correcl. Ali provisions ol law� nnd o�dinances quvr.min9 ihiv lype ol wmk v,iJ bo wmplieC <br />wil� wtw��er specifea liercin or noL T�a gian�inp ot a pertnM1 doe; not presume lo give amhonly to violale a rancel I�o provislon al any other ;la10 or bu�l law rcgulatinp conslmdion <br />TTa1 I am aulhotiLca Ey Ihc o+mcr ol Ini9 proOanY �o petlortn itlo work lor vAiiU1 appiiwlron is maEc and I ComplywiN I�9 Slatc ConVatlor9 Law 1B 211tCW and 796 YOOA WAC. <br />�------ /Z-z - /3 <br />O�nrod Ayont Slpnatnro Daie <br />(Rovised 3?01.3) <br />