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PERN6IT APPLICATION <br />BUILDING/MECHANICAL/PLUMBING/SIGN/SPRINKLERlDEMOLITION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 Cedar St., Evzrett, WA 98201 425-257-8810 FAX 425-257-8857 www.everettwa.org <br />��as- 3 <br />ADDRESS: PROPERTY TA%p PERMIT # <br />�5�'� t I-�o�./7' �ur��r'rL�rT t.��-�C�, <br />,L for new conslruction: Short Plal/su6division _Lot No._ (allach copy of long le9al description) <br />oo�,�czQc.? ��I.lGS'T.V'F).{iT, LL� Phon=�E-mail 3�+U—�psb �b���. <br />: A `C .�i cl�i'- I <br />�l <br />'�JI� <br />Ovmer Oa�nelsAc�enl _Com�actor _Contrector'sAgent __TenaNtm���ium�,�aai��;�rormmemaommao�r.rr��aowoM�n�no:Fam1 <br />,}GCf <br />G��AYS �a� <br />N��� <br />ILDING PERMIT APPLICATION <br />Lt � <br />Lic. # City Bus. Lic. # <br />�[7' al�one/Email �F�'�S�—�u'/k'T�� <br />i ACT POR PERMIT L�,I iNZN <br />D ��tiis r1-, <br />,F_m,�� �� -�uc �ss-s'�Ny <br />PRICE OF WORK <br />Exist�.ng Use ::f Building N� � HEAT SOl <br />ProG�sed Use of Building N�/k Gas__ Electric <br />Buildir.g type: _ Single Family _ Duplex _Townhouse _ MWIi-Family _ Commercial <br />Type of project: New _ Addition _ Remodel _ Re�air _ T.I. __ Sign _Sprinkler __Demolition_C <br />DESCHIPTION OF WORK(add�tionalspacepmvidedonfheback/: �� ��� �,r � <br />LA,vJscqt'�r.;G- T����6vE�7��1 SY57'Er'�l ce` <br />�� <br />MECHANICAL PERMIT APPL.ICATION <br />oi ProjocR <br />_Addn _Allcratlon _ Repair <br />�mber (p) o/lixfares <br />AIC — air handlina uni�s <br />' Num6er of F!eads <br />STEM <br />o( Use <br />PLUMBING PERMIT APPLICAT�ON <br />o�projuct; xFlew,_Addn,__A��erotion_Repair <br />Show Nunrbcr(N) [ � lixNrns <br />Other: <br />Gas <br />I herehy cert0y 1ha1 I have reatl and examinctl Ilus appbcauon antl kner. Ihe same lo �e ime nnd correcl. Ail provisions ol laws Pn0 ominances goveming lhis tyDe clv:oik �vill Ce tomplied <br />wn� x�elhe� 5pecifeG herein nol. T�e granling ol a pertnd Eoas nol presume l0 9rve authorny lo violate or wncel Na pmvision ol any olher sfale or local law reguluting consWdion <br />Tnat I am amnoriz �tn er ol t�is preperty to petlorm t�o work for which apDlicatio� is ma0e an0 i wmply c,it� tAa Staie CoNracton Law 1B 27 RCW antl 2962WA WAC. <br />-�.1� : %��� �/� <br />OwnodAuthorized Agont Signaturo Dafe i�°�'� �ed 3/'013) <br />