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PERMIT APPLICATION <br />BUILDINGlMECHANICALIPLUMBING/SIGN/SPRINKLER/DEMOLITION <br />CITY OF EVERETT PERMI'f SERVICES <br />3200 Cedar St., Everetl, WA 98201 - 425-257-8810 — FAX 425-257-8857 —vnw✓.everel�wa org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 Ph1 <br />/zo9 W t�e,K«TF_p P��.Y� IoOS OS7000p1l�OZ � ��rJ�L� <br />LEGAL for new construclion: Shod PlaVsubdrvi;lon h_y,P�F_ �[ TS Lot No.1 (� (attach copy of long Iegal descnplion) <br />OWNER <br />nadress 1 7 e�7 L�7 h� k I<! �.i! <br />CONTRACTOR {a �l� C. �i m H i�� <br />;.ad,�5� f� s z 7 N=_ 4��te, c <br />TENANT BUSINESS NAME <br />�l.vp <br />rr. � i <br />ionc/E-mail � 2 5_� <br />ry/State/Lp F_VC 2r <br />&ILc.» qLLP_L <br />G_" D��� f U f� <br />�/�20? <br />�I-�.5 -') y ( - 3 0 <br />���•, Nv�nEa <br />onc!E�ma�l �.+,..�ti.L—�' �i <br />BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK � I g O <br />Eaisting Use of ��dd�ng _ HEAT SOURCE: <br />Prepes_d Use of Dudding Gusx Eiednc___ OU�cr_ <br />E3uiiding type. � Sin9ie Family _ Dupiex _Townhouse _ iUIuIG-Family _ Commercial <br />Typc of project: _ New _ Addition _ Remodei� Repair, T.I. _ Sign _Sprinkler _Demolition_Change ol Use <br />D^_SCdpliOn 011'JCr1c jdd:�fr�q�15P,3ceFroY��CdOn frc:aC-f <br />you started working Nithout a permit7 _YES _NO <br />MECHANICAL PERMIT APPLICATION <br />olP�ojetl: _New_Addn _Alleration�fiepair <br />Show Number (M) ollixNres <br />� WG — air handGr�g untls <br />Forced air systems <br />� Gds pipinq <br />I 1Natcn c�ater <br />Gas <br />PLUMBING PERMIT APPLICATI7N <br />olPrqott: _Nmv_Addn _Ntcration_Repair <br />Show NumDcr!#) af flx(ures <br />j Clotheswasher <br />� l;�atcr h_ale: <br />Snk (servicelb2 <br />BackOc�v prevei <br />� Unnll <br />� Urinkmg Pounla <br />I Floordra�n <br />� Greasetrap <br />� Roof arains <br />Idedical Gas <br />_, I Othcr <br />I hereby cenity Ina1 I have read and e�amined Ihis appGcalion and know We same lo be Irue and correcl. All provisions ol laws and ordinances governmg <br />t�is n�pe ol work wtll be compliea wilh whelher speafieo herein er noL The 9ranting ol a permil does not Oresume to grve authonty to violale or cancel <br />the provision ol any olher slate or local taw regulafing conslrvcUon or the pertormante ol constrvttion. Thal I am auUenzed by the owner o11�is o�operty <br />�o perform the wort for which applitation is made and I comply witn ihe State Contracters Law 1827 RC4N and 296.200 W�C <br />�n�e..-� �, c. �� �, / Z� / 3-f 3 <br />O orlAuthorizod tigent 51 aWro �ale (Rev�sed 127J70) <br />