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PERMIT APPLICATION <br />BUILDING/MECHANICAL/PLUMBING/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 />%7 vs✓as�c <br />... <br />rnx a <br />tor new construction: Short PlaVsubdivision Lot <br />mail <br />copy of long Icgal desaiplion) <br />�y-�sy9 ��55� �e -/�m�s <br />.ne�' <br />�Owner _OwneisAgent _Coniractor _Conira!IofsAgent _Tenanl�musipm�aoaianero�ca,srn�rmmmom.oermdowoncinmospace� <br />!G <br />ILDING PERMIT APPLICATION <br />Existing Use of Building <br />Fwposed Use of Buildin <br />Lic. <br />PRICE OF WORK <br />8uilding type: �(, Single Family _ Duplex _Townhouse _ Multi-Family _ Commercial <br />Tvoe o( oroiect: x New Adddion Remodel Repair T.L _ Sign _Sprinklei <br />DESCnRI PTION OF WORK (addeionai space provided on me back) : <br />('ons��Nc�'en o� q nPw 5F� <br />MECHANICAL PERMIT APPLICATION <br />of Pro�ect: �New _Addn �Alloration _Ropalr <br />S�ow Numbcr (p) ollixtures <br />A/C — air handlina units <br />SPRI <br />Clolhes <br />Exhaustfai <br />Heat pump <br />UNt heater <br />8oder <br />Number of lieads <br />H U1T <br />Bus. Lic. # <br />of Use <br />PLUMBING PERMIT APPLICATION <br />ofPruject: Now_Addn _Altoretfon_Ropair <br />ShOw Numbei (H) o/ /ixtures <br />3 I Toilet <br />�Balhtub <br />�_ Lavalory (wash basin) <br />� Shower <br />� Kitchen sink 8 disposal <br />�__ Dishwasher <br />� I Clothes washcr <br />Medical <br />Ulhec <br />I �ereby cerlAyl�at I have read artl exam�ned Ihu appbcatian antl knvw Ihe same lo �e Irue nnd coned All p�ovlsions ol laws ond ordinances govrming ihis lype ol woh wdl6c complictl <br />wih w1lel�cr s�IMmU �crem or not. The granhn�J o� a p<rtnit aoes not p�esume �o grve au'nOnly to violatc or canccl lho piOvision ol any olher siale or IOCaI Idw rc9ulalmg Wnsirunion <br />T�al I am au v by �hc ownci ol t� Dropetly to perfmm t�c woik for wTiUi appliwlion is maec ana I compry w�h I�c Slale Contractors Law 1927 RCW an0 296.700A WAC <br />� <br />.��J � ��/ l3 1l� <br />OwnorlAu�horizod Agent SignaWre Daie (FevisedY.'O1J) <br />