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� � <br />� PERMIT APPLICATION <br />BiJILDING/MECHANICAL/PLUMBINGISIGNISPRINKLER/DEMOLITION <br />CITY OF EVERETT PERMIT SERVICF.S <br />3200 Cedar SL, Everett, :"JA 98201 - 4'25-257-8810 - FAX 425-257-£7f357 -:�r.•r.v everetl:va.org <br />APPLICATIONS ARG ACC[PTED FROtA � F.Pd TO 4 PG1 <br />TE ADDRESS: PROPERTY TIUf p PE ::IT n <br />(�71 !o L,� 2 i w��=�_ 1�1 �SC� %n I y D�S-� 1 <br />LEGAL far n�c: cor;Iri.ci�ca Shsn F�ios..o'_�r.i;io� <br />f <br />tL <br />BUILDING PERMIT APPLICATION <br />tLo _(�a.".ach r,opy cl'ong Icgal aeGu�.pt r,^j <br />i�.�-�e�E-ria�����iZSJ .3��—Z� <br />r''SI' - �I c �l <br />& I Lic �: � <br />���� <br />DNTA'7 FOR f <br />/�� <br />'.Grp.L-":PI <br />,Ii�f�Si zs%_-3il�F <br />T <br />C� , <br />l�/?S �?SJ-�/14 <br />NTRACT PRICE OF VJORK <br />E,�;; rc U>e cf B,: id �,-- S�--I� ---- ---- -- --- !-'E,\T SO�RC[: <br />Prn�:oSCd USn of f3u'�!Cing �� G<�: _ ' � C��.rr <br />EudCi�,tyoe: �SingleFamily _Duplex_Tar+niiouse _I.1uRi�Pamily _Comrnercial <br />Type of prcjecC _ Ne�.� _ Additton _ RemoAel _ Repav _ T L_ Sign _Sprir'aler __f;er�r, i��o-._. C^2�r_.e ���f l;s, <br />�Cscnpfion of VJork (aCtl,(:anal spaco F�o�'��'ed on fhe t;ck): �'; <br />1-u��5El 4 1.�Stvtc� 2 2oNr: �)u-�f ��55 �ic.�T � w-� �.� � Zr,�-� <br />ave you started workinc� without a permit7 _,YES _� NO <br />MECHANICAL PERMIT APPLICATION <br />ol Project', _ New__AAAn _Alteration _ReP:�ir <br />Show Num6crlql ol lixlures <br />ro-cea a�r sy�. <br />Gas pipiny <br />Wa;er heder <br />Gas ;ireal.+cc <br />Gas ranqe <br />Clothes �'ryer <br />Ran��c hUod <br />�xll.11lSl f;in <br />FICJI I)UiPt) <br />O:h�:. <br />SPRIhKLER I SUPPRESSION SYSTEM <br />Id�.:n-ber of Nur?s <br />PLUMBING PERMIT APPLICATION <br />olProjerl: __.New. _.AdJn ___l.Iter.�tinn _Repair <br />Show Numbr.r inl ol IRfures <br />Rool dra�.ns <br />>.tedical Gas <br />Other. <br />011'.rr <br />I r_.;y cert.ly .�L• I�.i�c rea� a^tl onr _d 1+; �(=P� i� o� dr,1 :r,.. ii �..:. ' ta 'e uuc hn� cerrect. All pio- .c � o( 40�5 dnJ Crtl��n,]rce5 g�vEmmg <br />,'�c 1'ipe of va4 vnil be cen,pl ed ;.�;h,.� soecd�ed ���erein or nel. Th� �ranbng pl a permd doe5 nol pre5ume (o g�ve aulhe��ly 10 violate or cana:! <br />'�-�� e�����s�cn of any clher state o cal la�.v r�gWaiing conslmction or the pedo�mance of conslruclion, Thal I am a�lhor¢ed by Ihe owner of Ihis pio,��:'y <br />;u ;:�•brm I C v �k fer �vrndi , �caUen :; madpvv�,d I comply :.iU� �he Slaie Conlrac�Crs Law 1827 RCVJ and 29G 200 WAC <br />�� ' u� ���-l�f ;-� <br />OwnerlA IhonzrdAyenlSignature i!;t�� �n�,i...:, ..:;,��'� .� <br />i �, <br />�.. <br />