Laserfiche WebLink
PERMIT APPLICATIO�I <br />BUILDING/MECHANICAL/Pi.UMBING/SIGN/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 <br />jYi/9 <br />v <br />v �3 a,^ 5 �c, <br />for new consiruclion: Shotl Platfsubtlivision _ ot No._ (a�tach copy ol long legal tlescdplion) <br />< !LliLN� � ,, •N �J�, (� phone�E�mail <br />S'r0 L^:YS 1✓ 7✓��L%�/ /r Z71 Qty/Slate/Zip <br />�ANT: Owner _Owner'sAgentt�Con�ractor ContractotsAgent Tenantem�mc�o�aoare,�erm�onsemr.omuev,..���ioao�.on��nmesrn:�, <br />ACTOR(;J;CcG��.-t_�c,�I .(��.c,��t.�'�,,^+ L&Ilic.# 7SS(��c"i �i'.� COEEus.Lic.#L+i: <br />, <ab <br />33�v � <br />UILDING PERMIT APPLICATlON <br />y2;" '3 i i 3/�/ <br />�iMT✓� i�NV:✓��.1 / <br />me/E�mail �/.'S� 32+'�(v�'�S .+C•✓�4�u��i��„i4+, <br />�NTRACT PRICE OF WCRK / `I /� � <br />ExistingUseoBuilding F�s�r(U�. HE4TSOURCE: <br />Proposed Use of Bmlding ��•' ��. �"� cas_ Eiectric__ Omer_ <br />Building type: � �� Single Family _ Duplex _Townhouse _ Multi-Family _ Commercial <br />iype cf project _ New _ Addition _ Remodel Repair T.I. Sign Sprinklet '�Demoli�ion •Change of Use <br />DESCRIPTION OF WORK (atltli�ional space provided on fhe backJ : <br />f <br />� 1 <br />f/c:�''� i-I�JUSt' ,r �C�,''�q� <br />� <br />MECHANICAL PERMIT ApPLICATION PLUMBING PERMIT APPLICATION <br />olProject: _New_Atldn _Allrratlon_Repair <br />Show Num6cr (IXJ o/ /IxYwes <br />i AIC—airhandlinauni�s <br />Other <br />ofProjecl _New_Addn _Altcralion_Repalr <br />Sink <br />Olher: <br />washer <br />I �ere�y mrti(y I�al l hava read anC examine0 t�is upplicalion ona know t�a same lo Oe Imo on0 mnect. All pmvisions ollaws an0 oNinonces Oova�ninB �hls lypa o(v.ro�k w�0 bo winpliN <br />v:^n r,hePier specilrod hereln or not The grantinB ol a permit Coes no� presvmo lo 0^'v auNonN �o vioWla or cancel Iho prcvisian ol any ather stale or lowl law repulatinp cons Wction <br />i�+at I am am�otlzeE Cy �he owner oll�is propeM �o perlortn Ihe woh forn�kh op0licotion ie maCe anE I eomply wqh Iho S�nle Contraclen Law IB27 RCW enG 296 200A WA�. <br />� � <br />%',�� / � /i %/ , h �' Z <br />% i,,�� {�_ �i" G � <br />wner/Authorizetl Agent SlgnaWre Dale (Revised 42072) <br />; �N•f <br />:O� <br />