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t <br />PERMIT APPLICATION <br />............--- <br />CITY OF EVERETT PERMIT SERVICES <br />3200 Cedar St., Everett, WA 982�� - 425-257-8810 — FAX 425-257-8857 — www.e�erettwa.org <br />APPUCATIONS ARE ACCEPTED FROM 6 AM TO 4 PM oFGY1T • <br />)DRESS: �O� 1!u M pNi An�A �t7 <br />fwnCwconsWdion: ShortPlaUsubdivisio� <br />t /�F�t9C�t r3,¢c�rXrXS eU�.+S <br />�qy�- &�n� ,4r� Nc <br />tACTOR �JR�n1S�� PU�tG � /� <br />2933� /z�ln� .4v�"' N� <br />IT BUSINESS NAME <br />.DING PERMIT APPLICATION <br />Lot No._ (etlach mPY of long legal desa�ptia�1 <br />�e�� �z:s-3aY-i399 <br />iyrs�ierov '� L-v��'L� r•t�A <br />6 � uc. u �.�G+a. io j(- z. 72 L s <br />iVN <br />–7Y{rL /Nl=� �� <br />DR Pt�c�i � <br />iLL�/ %��6/NSiLt/'L�� <br />PRICE OF WORK r 27 j"iJ <br />Exisling Use oi Building � <br />S �� Gas Electric Other_ <br />Proposed Use of Building <br />Buildingtype: ���9�eFamily _Duplex_Townhouse _Multi-Family 9 �� rinkler_Demolilion_Change ofUse <br />Typeofproject: _New _Addition _Remodel _Repair_T.I._Si n_ p <br />Descnption of Work (oddifbnal space provid�don �h� back): <br />Have you started working withoul a permitT _.YES ✓�O <br />Project: _New_Addn _Alleration_Repair <br />Show Number (N) a/ fixtures <br />PERMIT <br />ol Pro�acl: _Ner'i—Addn _Alteralion _,Repalr <br />Mediwl Gas <br />Othec <br />I hereby certily lhat I have mad and e�mined this afied h`erein orano The 9ra�ling o a permit dce�s n�ot Presume lo g �e'a ihorfly �o volate or5cancH 1ng <br />this type o1 work N+II be canplied wilh wt�ether spea <br />to peAorm lhe work for ,Hti � e orl I� ��' �e and 1�comP�Y � ohe StateoCont �ctors Law 18 7 RCWa alnd 296 2 0 WACY �� �r of lhis prope <br />I /' I� ��/ L�� � (Revistd 2R01 f) <br />�� Date <br />OwnedAuthonzed Agent Signatum \ � <br />Z <br />