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C� <br />i <br />PERMIT APPLICATION <br />BUfLDINGIMECHANICALIPLUMBINGlSIGN/SPRINKLERIDEMOLITION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 Cedar St., Everett, WA 98201 425-257-8810 FAX 425-257-8857 www.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROf A 8 AM TO 4 PM Q— 3-�J'—! <br />ADDRESS: PROPERTYTA%p PERMITp <br />i�iu ��raw,�Auo Evrn,e:� �tBZ01 (' i�,nR-nnG <br />lornew[sn5imclion. ShortPIa115u�Civision <br />� �_� 5 <br />'15 I �1 (� va A�_ <br />�.ANT: Ovmer Owners Agen! ✓C< <br />ACfOR 13q�i4n (�S �� <br />�u2� I�,O'E'`" h� l� <br />T BUSINE55 NAME <br />DING PERMIT APPLICATION <br />No. (aUach �opy p( long le�al descriplion) <br />�� '{25- �3y74- 3? S8 <br />o!_ v21.Gi f. W� "18 [-O 1 <br />_Conb9Cior'SAgent _TCnani�rmio�o..ecnl.n.�a!mnsemnommoe+nerioEo.wAmmesoacel <br />L 8 I Lic p <br />qc�oo S <br />,5���,.... n�� <br />o �iS—c <br />T PRICE OF WORK <br />E Bus. Lic. # <br />-2Z5� <br />��ye �t�.���s <br />Eaistint� Use ol �wlding IN �'4�"'� 1 1 HEAT SOURCE: <br />Proposed Usc ot Builaing S�h.�� 4� 1�_ Gax _ Eicaric� Oihcr _ <br />Budding type: __ Sinyle Family _ Duplez _Townhouse _ Mulli-Famdy _ Commercial <br />Type of pro�ect: New _ Addition � Remodel _ Repair _ T I. ___ Sgn _Sprinkler _Demohtion_ __Change of Use <br />DESCRIPTION OF INORK (adderonal snace 9rovitledon �he Dack) ( G� <br />��1nnt��. C�o� Ih bP_d�ow� A� '�rh Ih'�o °► bti'µ+roo`"^ or <br />.Fl�a � . <br />ol Projecl: _New <br />Show Ni <br />_Allcralion _Repair <br />ol�rfures <br />3ir han011nq u�tils <br />iilf Sy51rm5 <br />p10Q <br />�ICBICI <br />eplace <br />nge <br />; tlrycr <br />hootl <br />Numbe� <br />PLUMBING PERMIT APPLICATION <br />ol Projccl: _New _Addn ZC Rltera <br />Show Num6erlM7 o/liaYmes <br />Wlchen sink 8 <br />Olher <br />Gas <br />I fnveLy ovLly ibal I navc rea� and e.amm�tl IFe, aUVl.cal�on anA lnnw me sa�ne lo Ire Vuu and ennecl AOOrovismns ol lawv and ortlinances 9ovem:nq tlr.s �ype ol worF w+l: [re mmpLetl <br />vnni w1iel�er speolurJ �urrn o� not ihe yranf.nq o� a pe•m� ibe; noi prcsume lo grve aviho�M �� ��olaie or cancel IM1u proviSon o1 any olhe� shte m lou�l law rrgul.iimg «n.!ruction <br />Il�ai I am :wRmnmO bY I�e owner ol Ih�,, nmpeny la pedorm ipre work lor v,hcl� appLcal:on r marle nnd I eomnly wln �Im Slab Conbatlo¢ Law f B 27 RCW . nE ]96 2COA WAC <br />�.�I�TA�( �� ��Za ��3 <br />Owncr/AutForized Agent Signalure Dale (FrviscA C2077) <br />