Laserfiche WebLink
PERMIT APPLICATION <br />BUILDING/MECHANICAL/PLUMBING/SIGN/SPRINFCLER/DEMOLITION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 Cedar Sl., Everett, WA 98207 425-257-8810 FAX 425-257-8857 www.ever/e�ttwa.or <br />�nna.:sc. .. _ � �(/ ` � �—��. <br />TA% 7 <br />�Of p2W LOtI51NC1i00: ShOh <br />0 <br />(altach copy ol long legal descnption) <br />PPLICAMT:_Owner _Owne�sAge�t _Contractor _ConlractoYSA9en1 _7enanitm�,ic,o.+oe�:����,o�ro�,er.�rmmm,o..�Mrmm»on,nu:osp.,ui <br />DN7RACi0R V _ State Lic. # �pZ — � <br />,` 9 City Bus. Lic. # <br />!dress ���_'�.7�d� � ��� Phone/Email �(p�j( s� <br />:NANT BUSINESS NAME CONTqCT FOR PERMIT <br />PhonelE-mail <br />UILDIING PERMIT APPLICATION CONTRACT PRICE OF WORK <br />Use ot Bwlding <br />i Use o( Bw�din <br />Bmlding type' y Smgle Famity _ Duplex _Townhouse <br />OF WORK (arlm;�ona� spac� pmvid�d on me 5ack) <br />Muiti•Family _ Commercial <br />T.i. _ Sign _ S[rinkler <br />HEATSOUR <br />IZeplac4� 1�x�4�r �',�.v�tc4 ��c�o.� �'a� S1�oF o�F �lv Ino�a� <br />MECHANICAL PERMIT A?PLICATION <br />Typo ol ProjocF. _Now _Addn _qlroratlon _Ropalr <br />_ Show Number (M) ol lixfures <br />LER <br />Gas <br />Heal <br />Number <br />PLUM8ING PERMIT APPLICATION <br />of ProJect: _New _Addn _Alloretion _Ropair <br />Show Numbcr (N) o/ /irtures <br />Other <br />Olher. <br />I �creby cen,ry tnat I navc reaA ane e.aminM I�is app6ration ana know Ine same io Ce We an0 corred AII pmnsrons ol laws ond ard�aances goveming ihis ry�pe o1 waA wi� pe wmpbeC <br />wilh xfiether speG(ied �erei9 or nol The gianting ol a permrt docs nol presume In giv^ a�.l�omy to vieldte or wnccl I�e piovision of any tlhcr state or IOGV law regvlaling ConsWdion <br />That I am amhoiizeE Oy t�e oxner cll�if pwperry to pehorm IAe work Iei wn¢1� apphcalion K ma0e nnd I comply wiID I�e Sleh Conlraclers law IB 27 RC W anA 19G 2WA K51C <br />r uthori dAg 51 aturo Dale (Pevisetl3l1079J <br />