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PERMIT APPLICATION <br />BUILDINGIMECHANICALIPLUMBING/SIGN/SPRINKLERIDEMOLITION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 Cedar St., Everett, WA 98201 425-257-8810 FAX 425-257-8857 www•ev�re ga.org3 <br />IDRE55: .� � , „ <br />.Sv.%C C�.-:., . �.� <br />lor new construction: ShoA PlaUsubAivision_ <br />, ��.r,�,,; 1 ���!: <br />-� . -� � `-� ,c1,- ` <br />� ��c_ �� i�rr;.n c� <br />TAX N <br />s <br />No._ (allach copy of long legal descnplion) <br />PhonzlE-mail <br />�y2 -� k ll�d' � v�°� <br />_Owner _Owner'sAgenl �Contraclor _Conlractor'sAgenl _Tenanllmos�pmhaeaienerorromemo-ommeQ«�:ri000wonmmasva�o� <br />� �Ii.'M �I.1 <br />.]T. �U.,t�'1�L.U/`_`�l1���t <br />PERMIT APPLICATION <br />Use of Building <br /># 5�,...4Ll,upo�ic_C, <br />PRICE OF WORK <br />Proposed Use of Builtling -- <br />Building type: Single Famity _ Dup�ex _Townhouse _ Mulli•Family _ Commercial <br />Type of pro ect _ New _ Addition _ ftemodel _ Repair _ T.I. ._ Sign _Sprinklei <br /># <br />o( <br />DESCRIPTIONOFWORK(addilionalspaceprovidedontheback): �� �;« Fr:w� ri�+-�+�v ��t• <br />N-t'.W li�`.>-i,: (l�-� �..., �� �,��c-}•c. r�r�.,ic-� , I�� �-��� <br />I�v� ;� i:; <br />�S,S bi.,� �<i� trwt i:.�-.Kt,�- <br />MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br />TypoofPro�uct: _Naw_Addn _Alteretlon_Repalr TypaoTProJoct: _New_Addn _Altoratlon_Ropair <br />c�,,..�, w���6erlql o//ixfures _ Show Number(N) of flxturcs <br />Olher <br />SP <br />� hiedical Gas <br />"�,.n� z�. � Other: ^, G3 er <br />Num6er of Heads - <br />I �erehy ce�Ay Ihot I hew reatl and eKamined this application ond know Ihe samo lo be Uue anE corred. Aii Provisions ol laws ond ortlinances govemin9 t�rs type ol wo�k wiil be camplied <br />µith xrel�e� specdieE �erein or not. Tho granting ol a permd tloes not presume to grve outhorBy to vlolate or cancel the pmvision ol any ot0er state or local law re�utating w+sVudion <br />T�ot I em aulhoraetl � na owner ol lhis pmperly la peAortn Ne woik lor wtiich app�Kalion Is maEe antl � comply ai�� t�e Stete Contractors Law 78 27 FCW an0 296.PD�A N�AC. <br />/ %/ � y� �c`' /„� <br />� � Dale (Revised32073) <br />OwnorlAuthorizod Agonl Sl9neturo <br />