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r�� <br />� <br />PERMIT APPLICATION <br />BUILDING/MECHANICALIPLUMBINGISIGN/SPRINKLER/DEMOLITION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 Cedar St., Everelt, WA 98201 425-257-8810 FAX A25-257-8857 ewnv.everetlwa.org <br />t <br />�pf new COn5lfuCiipn: Sho�i <br />R <br />!L' /Z �} !J C <br />Ax a reanur a <br />���3o S�lSbo i',�n�- <br />No (atlach copy ol long Icyal descupt�on� <br />�� yzs �sZ ozo 6z <br />o �'I�.C/JGT7— /,iifJ A�10� <br />Oe/nCt _ONnCf'SAgeOI _COn;I�C10f _CCnIfB[tol'SAgeni _Tendnl�musipro��._oalv�e�e!¢nse.�t�'omoocwreneCo��:a��-n:nosvcu� <br />Lic N <br />UILDING PERMIT APPLICATION <br />Eaisting Use of Budding <br />T PRICE OF WORK <br />HEAT <br />Proposed Use of Ouilding l-A /� P e �vu�c K� c• � i i — <br />Budtling type� _ Sir9!e Famdy _ Duplez _Townhouse _ ��tulti�Famity _ Commeraal <br />Ty�e of pro�ect. New Addition _ Remodel _ Repa�r _.7 I_ Sign _Spnnkler _Demohtion_ <br />DESCRIPTION OF WORK (ada�honai space F�o+�Ced on me oack) - �(,(S e <br />//�e p�Ga-��-`� �"��-�i� '�,;� <br />MECHANICAL PERMIT APPLICATION <br />7ypeolProjecl: >�Nr�v_Addn _Alterallan_Repair <br />Shmv NumAer fa) ollixfures <br />—air hantlGnq unas <br />a <br />n <br />Numbcr of <br />Bus. Lic. K <br />ol Use <br />�� z_ <br />PLUMBING PERMIT APPLICATION <br />Typc of Project: ,�New _Addn _AllcraUon _Repair <br />Shaw Numbef IM) o( IirfulCS <br />Medical <br />Olher: • <br />sin�� .. <br />I nreCy cenAy ��al I Aave ieatl and eiam:n^C Ihis apF�•wlicn and kno��v I�e same Io be Ime a�0 corred All piovisions ol laws and ar0inances govemin9 IArs ty0e ol �so�k �n9 be comO��eE <br />x6�.n �nncl�er spenfe0 Oere�n or nol. T�e grJnting N p pertnit eaes nol O�esumc lo grve aulnonly 10 vio�a!e or Wncel Ine prov�sion al any el�er slale or IOG�I Ia-.v regulatng cons�Ncllon <br />Thai I am aw�o�ized Ey me oxnv cl tnis pwpeny lo peNorm t�e woik for w�:ch appi'.caaon is maae ana i comply wuh i�e Siam Convaclon law 19 27 RC'N and 796 200A �VnG I� <br />/��,�- ��.�w�-�-- 7 - 15 - .Zc� � �� L <br />OwnedAulhorized Agent Signaturc Dale (Revised 3i2013J <br />