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� <br />PERMIT <br />� <br />�4PPLICATION <br />BUILDINGIMECHANICAL/PLUMBINGISIGN/SPRINKLERIDEMOLITION <br />CITY OF EVERETT PERMIT SERVIGES <br />3200 Cedar SL, Everett, VVA 98201 425-25?-8810 FAX 425-?_57-8857 www.everethva.org <br />s -a6--�5 <br />w nnoccc. t+NOPFPN TA% H PERM1IIT A <br />S YVes{ lhuk.�eo <br />for ne�,v COnstrueticn Short PlaUsubtliw,wn ,_Lol No <br />(atlacn cepy ot IOng iegai descnp;ion) <br />IOl7s WGtit IY�NILfIo 2Wo �C�ry/S'ate�Zip �ve��1 vP� N8203 <br />ANT:_Owner _Own=YsAoenl �Conirado� _Coniraclor'SAgent �Tenani(mc;ipro.cenic��,erorcrosoniwmmoow�e�ioao�oainine:oa:e; <br />TOR <br />QiDN� l...i'f� <br />BUILDING PEF2MIT APPLfCATION <br />UseolBuilding 5�^�4 <br />Lic J� �nhGG�`i <br />Phone/EmaJ <br />^p Cdy Bus. Lic. # <br />PRICE OF WORM; <br />Proposed Use of Building S� i.. .,._� ] � �=5_ <br />�uilding type: �Single Family _ L�uolex __Townhouse _ Multi-Famlly _ Commercial <br />Type of pro�ecl� New Additlon _ Remodel _ Reoair _ TJ. _ Sign _Sprinkler _De <br />DESCRIPTIUN OFWORK(adae�ona�spacepm�+dedonrhebac.%) <br />2s' Ii�eK 28a c�atf M oda L�� /A>fz l� Cr� �l Y-iesr S� /.� S, Sta� <br />13 $/v9 �%• M�c,e r�.. W.4C. Iw� }�4C C��.+Pona.i't <br />� v�Gt <br />olProjecF. _New_Atldn _Alteration_Repair <br />Sbow Numbcr (N,10/ /ixtures <br />A/C - a!r handl�ng unils <br />NKLERI <br />- 3-2+k -'7 l Cog <br />�p��� <br />HEATSOURCE. <br />__ Electnc_ Othei-_ <br />notition Chanoe ol Use <br />Typc ol Project: _New _AdCn _Alleration _Repair <br />ShmvNumber(K) o!lirtores <br />O�her. <br />Other. <br />washer <br />Gas <br />I h:�eby cerlRy 1�a11 have read an0 e.aminetl this appilwtion and know Itre same to 6e Ime an0 careC. All provi;ions ol laws and orC�nances goveming �h�s lype of wo�k w�:l Ue :ompl�ed <br />wi h w�eIDer specifed �erein o� not The 9mn;ing of a permil Eoes nol presume l0 9ive auNonly lo viola�e or cancel I�e pmvlsion of any olher sta!e or locat law regula6ng construi�ion <br />Tha� I:imPuthori:ed b Ine o�mero� Ihis pmpe�y to peAortn Ihe work lar whith applicabon is ma0e anE I wmply wilb Ihe Slaio Conirac;ofs Law 18 27 RCW antl 29fi200A WAC <br />-�� � $�Z 4 �/ �" <br />r <br />w rjl thorizetl Agent Signalure �— Uale (Rcvi^ed 4/2015) <br />