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PERMIT APPL6l;ATION <br />BUILDIN�u/MECHANICALlPLUIV161NG/SiGN/SPRINKLERlDEMOLITION <br />CITY OF EVERETT PERMIT S�RVICES <br />3200 Cedar St., Everett, WA 98201 425-257-8810 FAX 425-257-8857 www.everetlwa.org <br />�n �3��-1 y <br />rax u <br />lP...�wZ 2��x;rZ Rd EJ,eeF�t�4— <br />for new conslruction: Short PlaVsuodivision Lot No._ (at�ach copy of long legal descnption) <br />'13 t gj�.o.J ¢.z <br />(��a <br />O++r.cr _Ov:neisAgenl _CaNraetor _CoNractafsAgent _Tenanllm,m�,m��,aaaieneroiwnsemuc.rmac.:�.�•r�.�ca++oM�.,�s�sr�Rl <br />NG PERMIT ANPLICATIQN <br />Existing Use af BuilGing <br />Proposed Use of E�uiltling <br />Building type:� Single Family _ Duplex _Townhouse _ Mulli-Famlly <br />Type ot proiect� New AdCition X Remod:l Repair _ TJ. <br />DESCRIPTION 4F WORK (adCuonalspacuprovidedon me back) <br />lv��i-�Pr�i =�Y� ���\r�/ <br />O <br />MECHAINICAL PERMIT APPLICATION <br />Type ol Projoct: _Now _Addn _Alteralion _Repair <br />—air <br />ISUP <br />M <br /># <br />Bus. Lic # <br />PRICE OF WORK <br />HEAT SOURCE: <br />Cf <br />Commercial <br />of Use <br />PLUMBING PERMIT APPLICATION <br />TypoalProject: _New_Atldn _Altcratlon_Repair <br />Show NumbcrlMl o/ fixfures <br />Floor d� <br />Medical Gas <br />Other: <br />Other: <br />I �ereby cenrty Ihat I �ave read and examineE this appGwuon and kr.ow ��e same to De Irue onC wrtect. Ail provlsion; of �aNs and or�lnances 9oveming this iype ol work w+0 6e wmp!md <br />wCn vrt�etner speaGea �erein or nol. Tho g�aminq ol a permn tloes nct presume togi�e amhority to violaie cr wnccll�e pmvision al any cNer slate or lawl lan regWaling mns!rutlion <br />T1ia11 am amhorized Dy t�e �.me� el l�is pmperty lo pertorm Ihe work for wricl� aDPliwlion is ma0e an01 compty wah I�e Slale CaNreqoo Law IB 21 RCW anE 29G.ZOOA N'AC. <br />10—'T� — � L� <br />ner/AuthorizeJ Agent Sig na W re Dale (ReviseJ 3Q073) <br />