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�ERMIT APPLICATI� <br />BUlLDINGIMECHANICAL/PLUMBING/SIGN/SPf21NKLER/DEMOLITION <br />CITY OF EVERETT PERMIT SERVICES <br />32011 Cedar St., Everett, WA 98201 425-257-8810 FAX 425-257-8857 ww�rr.everettwa.org <br />� -ZZ �-1S <br />ADDRESS: <br />lor riew ca�stnY.�m' Srort <br />OWNER����// l�o�f�N� <br />Bax /s�7 <br />:,� Owv:r _ O+mers Agent _ Cor',raCo+ <br />�,�ivOd/�r.J <br />I aoys9z i I�1 i�°� - o'--� <br />ao 0000v <br />Lct W._ (aCaU� p� of brg Ic;al desrnption) <br />� PnonelE-mvl 5'z s'zs8 9z z z <br />-- G�,�,�«o E-r,�-,��rr, �,�� 9�zo� <br />, <br />_CmtraclorsP&en! _Trnar.tM,wm�w.bee.mmud,rm,erc....ew.a.e�a. <br />State Lic. # �[�MC �5 Ip 1 Z <br />P�.oImJEma�l <br />CONTACT FOR PERMIT qND Y <br />�,���.��� S�z.� Z 93: <br />BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK <br />Exisling Use of Building SFic <br />Proposed Use of Buildina SFj�C � Ga <br />Building rype: _ S�ngle Famiy _ Duptex _Ta«nhouse _ Multi-Famity _ Commercial <br />RIPTION OF WORK Wdd�tlma� space povloed on tho Dadc): <br />��� �l1(� 1�' �"Gt I'1 � � -M�'!'1Gt Ge-- <br />MECHANICAL PERMIT APPLICATION <br />otProJoct: _Naw_Aden! <br />Show NumDer G ol <br />A/C — air <br />ViR:ltiTi <br />ES <br />_Ropelr <br />SYSTEM <br />Bus. Lic. # <br />E�L TNF— <br />/� - TE. <br />�. a� <br />BING PERMIT APPLICATION <br />o1ProJect _Now_AAEn _Altomtlon_Repalr <br />SAnwNwnDer/W o/fla'Lne9 <br />Medieal Gas <br />Orier <br />I �creb{ antYy Nol I Aeva reaE srC n�mheE tl:u appfratbn enG If�on ITe enme lo Oa true and mrte�3. P➢provMbnf M Lrn anE oN�nencee govort+n0 rtiV ryyo olwry vA Ea eomp <br />wth wtie'.�er npoo9eC �omm m �ot ?Ta g2aLhg of e perntl tloa� not pnwme ro pNo eut�oeTy;o vb�ale or omel C�e proY.u�n al nny oTm etnte orb�'a� Lrv rogu'a:ng �pnsWcibn <br />TTaI l am ouso py Vie ar ol r� propery io pohrtn tl+e wrR for V� appSUNm L+made enE I mnpN MT Ne S!a'.e Cmtrncort Lmr t9.71 RCW anC 298100A W/+C. <br />�� �i'�%s-- <br />OwnarlAuthorized Agant Slgnoturo Datn (Ravised 4/l075) <br />