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PERMIT APPL�ICATION <br />BUILDING/MECHANICAL/PLUMBING/SIGN/SPRINKLER/DEMOLITION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 Cedar St., Everett, WA 98201 - 425-257-6810 — FAX 425-257-8657 — www.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM C/ �- a a�'�I <br />.EGAL tor new construction: S!wrt PlaVwbdivision�dllr�tk(' AJ �� ��-'�'�ot <br />)YYNER P2c>JI Oi.wtL� i-iW-A� L'YN i SVCS. Phone/E•rtu <br />ndress ( 9 0 � L i DW S W. CiryiState�L <br />�ONTRACTOR '�%—'F3 'p L 8 I Lic. # <br />tldress <br />ENANT BUSINESS NAME <br />'�P�t'� �-1 �. c,u �-t S � �,-t�+-�--1-t3 C��� <br />PhonelE-ma <br />tU1LDING PERMIT APPLICATION CONTRAC <br />`� t-1701'f'vL � � ���� 'v/� <br />�� <br />No. �} (attach copy of long legal tlescription) <br />iil <br />a v� ►-t . l.l. �4 4 a u S'} <br />Phone/Email <br />� PE� <br />Y4L �gGl�i'��C_/ 1��lNl�t IJ��S1l� <br />� 4rJ-5-�2$--c�3:i5' <br />i PRICE OF WOR 1�i 0. a� 1� <br />Existing Use of Building t'`1 �!R C�w'L_ HEAT SOURCE: <br />Proposed Use of 8uilding �� l�� c�� Gas Eleanc Other <br />Building type: _ Single FamHy _ Duptex _Taxnhouse _ Multi-Family � Commercial H1A'� uw� P� <br />Type of project: _ New _ Addition _ Remodel _ Repair� T.I. _ Sign _Sprinkler_pemolition_Change of Use <br />DescriptionofWOrk(addifiona(spacepmvideContheback):4;,,,.�6.�:N� -r.�.,"��,_S?�y`.�U.i.AL� l�V�l,l) <br />pG ,.n�-u�taL u.�u�c.-(-�3Nw t_@��.��i�l �H;��,,; t-�F�dt�.�� r,� ; �. <br />��'fi 7' <br />��� �,���,�,L �: ..»r (at,��,��s -IEhiA..,T—�,�rY���, �) <br />Have you sWrted working without a pertnit9 _YES _NO <br />_New_Addn _Altaration_Repelr <br />/ <br />Number of <br />aProJact. _Naw_Addn _Albntion_Rapnir <br />Medical Gas <br />Other. <br />I hereby certify that 1 have read and examined Nis appliwtion antl knav the same to be We and oortect. AII provisions of laws and ordinanees poveming <br />this lype of wwk will be complied with whether spedfed herein or not. The granting of a pertnit dces not presume to give aulhwity to vioWte or cancel <br />ihe provision of any other state or local Ww regulating construGion or the perfortnance of tonsiruction. 7hat I am authonzed by ihe oMner oi this pfoperty <br />lo perlorm Ihe r which appliwtion is made antl I compy with the State Contreaors Law 78.27 RCW and 296.200 WqC <br />�..���riz� ent SI� � <br />Date ��� ����� <br />