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PERMIT AWPLICATION <br />BUILDING/MECHANICAL/PLUMBINGISIGN/SPRINKLER/DEMOLITION <br />�— CITY OF EVERETT PERMIT SERVICES <br />3200 Cedar St., Everelt, WA 98201 425-257-8810 FAX 425-257-8857 www.everettv+a.or � <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM I"� � 3 <br />�� ^ � � T PNO�ERNTA%N P IT# 'D <br />ADDRESS: �y OC S � Z�00% DD- �o <br />for new consiruclion: Shott <br />ER <br />_ O�mer _ O��vners <br />No._ (allach copy of long legal descnption) <br />_Contractor _Contracror'sAgent Tendnt(mu�ipmr'i�e�kareRomer.�homc.vow-�ubaow�a�nt�aspa:e� <br />S/// %� <br />IUILDING PERMIT APPLICATION <br />Use of Building <br />L 8 I Lic. # COE Bu <br />P�one/Emaii <br />CONTACT POR PERMIT iJ� N N.�F <br />/ /� 7p/' <br />PhonGE�mail (7 7J S ��• �✓/ v <br />CONTRACT PRICE OF WORK �C� � <br />Propased Use of Building � ""' "--"�-- — — <br />Building type: j�Single Family _ Duplex Townhouse ,_ MWti-Gamily _ Commercial <br />Type o( pmjecC New _ Addition Remodel _ Repair _ T.I. _ Sign _Sprinkler _Demolition_Change of Use <br />DESCRIPTION OF WORK (addi�ional space provioedon me back): <br />,�_ �f1 �.Q�,�f /���1��1 c��.= �r'/�✓6 �P�s�DE"i✓C, �' <br />���� lN 6 �✓A,w-S /�.�� ���,.�.5 I� wA�- �n/� ✓=�9770 .J <br />MECHANICAL PER IT APPLICATI N PLUMBING PERMI APPLICATION <br />of Projecl: ,_New _Addn _Altcrallon _Repalr <br />ShowNum6er!#1 o/liufums <br />I AIC—airhandlingunils <br />fan <br />otPro�ect: _New_Addn _Alteratlon_Repair <br />ShnwNum6crlpl o/llxfu/e5 <br />Other: <br />NumberoFHeads � vme�. <br />1 he�eGy ceNry Ihal l havereaa anE ezamined l�is opplication onC know �be same lo be Irue an0 rortecl. All provisions ol laws anE orEinancee qoveming Ihis rype cfwork wi Ce complietl <br />rva� w�ether specifed herein or noL The Oranting of a pertnil Coes nol p�esume lo pive aWhony lo vi�iale or cencel th^ provision ol any o1�=t etale or local law repulaing canslmdion <br />T�ot I am a �onxed by Ihe owner o/ lhls pmpeM �o pertortn lho work for which applicatian ia maEe eni I compN wn� ��e State Contraclors Law 18.27 RLW anC 2PB.IOOA K'FC. <br />� / <br />Owncr/Authun .ed 9ent 519wlurc Dale (Revisetl 6i2012) <br />