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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 />TAIf p <br />lor new constructiore Short PlaVsuhdivision Lot No._ (altach copy ol long legal tlescnplion) <br />t \M_ I l�{1NA Sli✓ I Phone/E�mail <br />�� <br />_Owner _OwneYSAgeM �COlt�fdCio� _COnl�d[IOYSAgenl _Ten�fl��musipio��aaaienerolcansemhom��aonnertoeowoMinmespace� <br />BUILDING PERMIT APPLICATION <br />�State L:c. # fNf(� <br />JQ {v// (p Z�%� PhonelEmail <br />CONTACT FOR PERMIT <br />'ra,y 2o�+t m �- I <br />PhonelL'�mail � A{�J� <br />CONTRACT PRICE OF WORK <br />Dus LiC. # <br />i <br />✓/�CS.CO�VJ <br />ing Usc of Building �"%� HEAT SOURCE: <br />osed Use of �uilding��. Gas_ Eiectric � Omer_ <br />ling type: � Single Family _ Duplex _Townhouse _ Multi•Famity _ Commercial <br />of projecC New Addition Remodel Repair _ T.I. _ Sign �Sprinkler,�Demolilion Change of Use <br />iCRIPTION OF WORK (addirrona� spaco provided on mo vack : <br />2ewcove o(oO C�Gj�.e ,�- �'lltyA� Ad�,`�n� on c,1zs-f- S�de o� i�o� 2 <br />MECHANICAL PERMIT APPLICATION <br />Typo of ProJecl: _New _Addn _Alte�ation _Rnpafr <br />Show Numbcr(k) ollixtures <br />AIC — air handlinn unitc <br />Other <br />Number of I leads <br />PLUMBING PERMIT APPLICATION <br />oi Pro�ect: _New _Addn _Allerativn _Repair <br />Show Numberlpl ollixtures <br />WBlef hCa1C! <br />Sink (service/bard <br />(3ackflow prevcnU <br />Uiinal <br />Urmking Founlain <br />Roor drain <br />Other <br />Olhcr. <br />I Gas <br />I heieby cendy thal I �ave �eatl ana e.amineA Ihis a�.pUcaiian an� 4now ii�e c�me lo be tive antl conecl All pmvisions at laws ana orU:nances povemin9 this type ol woM1 wll be comp!ied <br />wn� wtml�cr speclGed hcrcm^ or not. Thc g�aneng of a per es not presmnc to grvu amnn;iry Io vioialc or cancel Ihe provision ol ony oi�er slale ar Ioeillaw rrgulaling consfructmn <br />lhal I �m authonlcC � IOcpJmet oi Ihis p�opeqy to p^A .n e work lo� HTiU appLwtion rs ma0c anU 1 comply w�h I�e S�alc CoNradors Law 1 B 77 RC W and 296 700A WAC. <br />(ReviseJ ;i?O1 J) <br />