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PERMIT APPLICATION <br />BUILDINGIMECHANiCALiPLUMBING/SIGN/SPRINKLER/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 />;�,�is ,� <br />(or new consWction: Short PIaL <br />t ��ar; �C,� c I� (e.�'' <br />�DIS VM11orqu� <br />Owner _ <br />KG� <br />��a:c, <br />No._ (attach copy ol long legal desaiplion) <br />2�-3v7-t32vJ <br />�P�-�-t . w�4 5 a 2 <br />Agent _Con�raetor _Contraetor'sAgen� Tenant�moslpraraaalenerolwnsemhommaonnerlodoNoikinmespace) <br />LDING PERMIT APPLICATION <br />Lic. # <br />Lic. # <br />,CT FOR PERMIT jzycn �-�p, S ���u�,1 <br />�mail �i Zti �i �l b-� C �(�, V <br />;ACT PRICE OF WORK ��, DOO <br />HEATSOURCE: <br />�.isting Use af Building <br />oposed Use of Building <br />iilding type: _ Single Family _ Duplex _Townhouse _ Mulli•Family _ Commercial <br />pe o( project� New Addition Remodel Repair T.I. _ Sign _Sprinkle <br />ESCRIPTION OF WORK (add�rona� space provided on mo back): <br />j?r�IntC �II e-k�U•�a^ Ca.�cvc�C jew`Cr �D�p� � �irle) <br />MECHANICAL PERMIT APPLICATION <br />ofProJoct: _New_Addn _Attoratlon_Rupalr <br />Number of <br />I �+�t <br />o( Use <br />i1 o i i S�� -�>> S A�r � <br />PLUMBING PERMIT APPLICATION <br />o1ProJoct: _Now_Addn _Alloretlon„�Ropalr <br />ShowNum6er(N) o/lixtures <br />Other: <br />Gas <br />I �ereby cenAy Ihat I have read enC a.am�neC ihis application a�d knorv Ihe sama lo �e true nntl corretl. All pmvisions ol laws end oNinanms poveming t�is type ol work wll be complied <br />wit� wt+elher speufetl herein � nol. T�e gr neng ul a pem�il tloes not presuma Io give omnomy to vblata or cancel lhe pmvision ol any otner state or Iocai taw regulating construnion <br />Thal I am am�� etl Eyl�e own t mperty to pedorm t�e work lo� which appl'¢alion is matle en01 comply wAh the Stele Ccntrecbrs La�v 18 27 PCW anE 2?G2WA WAC. <br />-' � � < / <br />� .�,- _2. �,�_� _ � �Z�;/3 <br />O� nedAull�,rizedAgentSlgnaWro ' Date (Revised3R973) <br />