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PERMIT APPLICATION <br />BUILDINGIMECFAICALIPLUMBINGISIGNIS4NKLER/DEMOLITION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 Cedar St., Everett, WA 98201 425-257-8810 FAX 425-257-8857 www.everettwa.org <br />%-- P-7--lS' <br />SITE ADDRESS: PROPERTYTAX ll ERMIT M <br />�LI% Lc, i- S I ooys 9Z ee mod Gov - D <br />LEGAL for new conslnuccttii^on: �Short Plat/subdivision �l Lot No:'/_ (attach copyoflong legal description) <br />OWNER ����LC// lr1l'//l/l/NC7 !7�//D� Phone/E-mail �7 2t.5777l�/0/, ZpZ L, <br />Address fD�dX �,> X CirylStatefLp /�c. 7 /.v{4 <br />APPLICANT:XOwner _Owner's Agent _Contractor Contractor's Agent Tenant lmvnpmvwealonorofwmminom me owner to do wanwmme span) <br />CONTRACTOR ���� <br />State Lic.If D65(''C 19101 7- City Bus. Lic. #0- I <br />Address <br />PhonelErnwl <br />TENA/NNTT BUSINESS9 NAME <br />CONTACT FOR PERMIT ,gA/,41 Y E c?TMF <br />6.alile <br />2� 6 — �E <br />✓ <br />Phone/E-mail '37 <br />BUILDING PERMIT APPLICATION <br />CONTRACT PRICE OF WORK .600, 0� <br />Existing Use of Building J�/Cic <br />Proposed Use of Building SF� <br />type: _Single Family _ Duplex _Townhouse _Multi -Family _Commercial <br />)N OF WORK (additional space provided on the back): <br />ITJ <br />MECHANICAL PERMIT APPLICATION I I PLUMBING PERMIT APPLICATION I <br />of Project: _Now_Addn XAlloraticn_Repair I (Type of Project: _Now_Addn -Alteration ___Repair <br />Heat um I I Backgow preventer (inside bldq) <br />Unit healer Urinal <br />Boller Drinking <br />Fountain <br />Refd eralion Floor drain <br />WoodstoveI Grease trap <br />Ducting Roof drains <br />Other Medical Gas <br />SPRINKLER / SUPPRESSION SYSTEM Other. <br />Number of Heads Other: <br />1 hereby comfy Ih at I have mod and oxamined Ihb appllcnlbn and know No same to be euo and coned. Ae pmvlstons of laws and ominanros governing hla typo of work will be compl <br />with wholher spat ap he Minor not. The granting of a permit doe not presume to gNe aulhomy to violate or canceithe provision of any olhor stale or Iow1 inw mguLiling Lonslmd in <br />Thal 1 am oe o o by the o of this property to Podortn m� o forty IN appfvallon B made and 1 comply Win Uo State Contractors; Law 18.27 RCW and 208.200A WAC. <br />OwnerlAuthorizad Agent Signature 9 Date (Rovlsod 4/1015) <br />