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PERMIT APPLICATI� <br />BUILDINGIMECH�ICAUPLUMBINGISIGNIS NKLERIDEMOLITION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 Cedar St., Everett, WA 98201 425-257-8810 FAX 425-257-Ed57 vr.v�i.everettwa.org <br />q�az—�� <br />E AO�RE55: ^' � <br />� <br />pE�Rh11T b <br />?q j ���DO o01� i"Vl ��i�' <br />_EGA�!ane�.+wnstnxLon�. SncrtPlaVsuberv�.s�cn Lo1No__ (�����DY���=^���a!4�''Up�ion) <br />JWNER �U�KC� 110l�f�NG !7U%y� Phc^c�E�ma�l J � �C,.S a , � � � <br />�ccress f0 �D.Y �.�� C�ryiS�atJL�a ��i��� �� GO z��� . <br />APPLICANT;,p_,Oarer _OFnefs.9ent _Conirapor _Ca'�InCoh�dr.nt _Tenanitm�..�;2.a.•uco�nx.+m+r�7.a"��=b`^�^�^^+.^'-'� <br />R f/�OG <br />�,�INO (//�GJ <br />UILDING PERMIT APPLICATION <br />�� tt/r�+��yAC �5 i0 � Z City eus. Lic. # <br />Ph^r�mal <br />IR PERMIT �N� y <br />�r, <br />PRICE OF WORK <br />Exl;tir.g Uso of Builaing SF� � <br />Proposed Use of Building <br />[3uiiding type� _ Singlo Family _ Cuplex _Townhousa _ �.lulti-Famity _ Commeroal <br />DESCRIPTION OF 'NORK (add�conai sveca v�v�ded on �no cacx): <br />��;LV ��jLCE.� <br />MECHANICAL <br />o1Pro�ecC _Now_Addn! <br />Show Numbor (tlL <br />A1C — air <br />SP <br />Number ol <br />APPLICATION <br />_Ropalr <br />FL Ti✓� <br />,/�-TE <br />� �� <br />HEATSOURCE� <br />i1 E!eCric Other <br />=mni�n�.nn C�anoo o( Use <br />PLUMBING PERMIT APPLICATION <br />TypoolProJecl: _Now_Addn _Allontlon_Repalr <br />snnw Num�crlal ol flxNros <br />Rool drains <br />Medical Ga <br />Other <br />I nrr�try wN'y I�nl I �avo ro aC anE oumno0 C�If apptlr�!bn nntl tnow L�e semo lo Oe true arE cortecl. pn pm•Iskan o� �an'e anC artl'.nances gova+'�Inp P.le typa ol ..cn w'➢ Do comp <br />ra'� uTcl�cr ;poar.oe nora:n or nd. To B���rG cl n pc�mtl Coee ncl o�:uma m 4!.e am�or'ry to vbialo cr e�ncel �'�e pmviyon cl enY ol�ar ��iie or loeil tj« m�u�ing co�sta�Gbr. <br />;Tal I am o��by 1� onnor ct :Mb OrvPcr;y lo Dartoml tli o work fo� wM1YT apC�tlon lt ma0e enE 1 mmDN �J' Ne $10!e Cd+IratlOn law I B 21 RLW dn0 290.2COA Y:AC. <br />Ownor� hcrlxed Agont Slgnaluro ��1v�jJ ^ Date (RevisCd �R015) <br />