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PERI"dlbT APPLICATION <br />BUILDING/MECHANICAL/F'LUMBING/SIGNISPRINKLER/DEMOLITION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 Cedar St., Everett, WA 98201 425-257-8810 FAX 425-257-8857 www.everetlwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM 5�/ O—/ 3 <br />iynr r � r�c�ic'��c� ('�L �'1' I Uo �� <br />lur new conslruction: Shotl PlaVsubdivislon La1 <br />t �F/'� N/��yf � Pnone/E-me <br />P�i�o4- 00� <br />(altach copy ol long legal tlesuiption) <br />•;/J j J'Z�� `�>l, � City/State'Zip�6ilJF�/ �(-� ���;�- <br />'ANT: i�Ovmer OxnefsAgenl Contractor ContractofsAgent _Tenanllm�,�v�,+�•+kmroiw��embmm.o..�erwao..orc.,meio�el <br />ACTOR %F� i� L& I Lic. # COE Bus. LiC. # <br />f �: � � t'� ,, • �,�� y'� <br />Phone/E�mail � i <br />LDING PERMIT APPLICATION CONTRACT PRICE OF WORK <br />ng Use of Buitding �� �"%r ��"� '� F/� f^/( � 1� �- HEAT SOURCE: <br />sed Use of Building <br />��/ !%� Gas_ Electnc_ OIAer_ <br />ng type: �[ Single Family _ Duplez _Townhouse _ Multi-Family _ Commercial <br />of projecf New Addition Remodel Repair T I Sign Sprinkler Demolition_Change of Use <br />�RIPTION OF WORK (atlCi�ionai space pmvidedan �he 6ack): � �� / <br />, i... / •o <br />,;' ,-�"/, .{ •�`= � � !' �' `- F/�� i � % - G � `< / J <br />, <br />MECHANICAL PERMIT APPLICATION � � PLUMBING <br />o1ProJect: _New_Addn _Alleratlon_Repalr <br />Show Numbcr (a) ol flztures . <br />Number of <br />ION <br />ofProJecl: _New_Atldn _Alteration_Repair <br />healer <br />I �eioCy cenly ihal l havo rcatl an0 e•ammc J��is opplicntan and know I�a samo to bo W o and eortecl. All pmvisiom ol lmvf and ortlnanem gavemnp Nii h90 ol �w�k wi0 Ee compied <br />v, nn ��helner spetificd hercin or nat. 1 ne praNrtg ol e permit Coef nal pmeume lo B� ouNonry to violale a cancel t�o proWfbn ol nny ather sLilo or local 6w repuWtnp conslruNon <br />Tfat I am auNonzed by Ilm oxner o1 V�is Froperry lo pedortn tho �vmk lor whiU npp6coion if ma0e end 1 comptywlh Ne Stala Contraclon Le'.v iB27 RCW enE 29BIOOA WAC. <br />f <br />✓ / . . <br />Owncr�l�tliorizetl Agenl SlgnaWre �ate <br />(Revisetl fi20t4) �/ � <br />