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( <br />PERMIT APPLICATION <br />BUILDING/MECHANICALIPLUMBING/SIGN/SPRINKLER/DEMOLITION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 Cedar St., Everett, WA 98201 - 425-257-8810 - FAX 425-257-8857 - www.ever�ttwa.3 i y) ( <br />pPPLICATI0N5 ARE ACCEPTED FROM 8 AM TO 4 PM <br />ADDRESS: PROPERTYTA%N PERMIT• / <br />�l5 W MuDlILTED _�3�Vp <br />for new conslruction: Short PlaUsubdivisian_ <br />i �C�.ALD R• V`�111-LE/Z <br />25i5 W. Mu�ci�-rec� �c-vL <br />'ACTOR /} AVANCL � CO�VS % 1'LU <br />P,o. a��� �oe:� <br />i`..i,oi-u,;.l.E. WA �SZ? <br />T BUSINESS NAME <br />DING PERMIT APPLICATION <br />No._ (attach copy ol lon8legal description) <br />Phone/E-meil �125-�17-Zo99 <br />citviStatelZio EVERETT. iNA <br />I Lic. # <br />3�0-(� <br />03- <br />o��v <br />PRICE OF WORK �(� 51 S 9E <br />ng Use of Building _�i�� � D�1>T7A� � "`�� �v�,.v�. <br />�sed Use of Buiiding�:(�1�C: Ni /A L Gas Electdc_ Other_ <br />ng lype: �Single Family _ Duplex Townhouse _ Mulli•Family _ Commercial <br />of project: _ New _Addition ,_ Remodel �epair_ T.I. _ Sign,_Sprinkier_Demolition_,Change of Use <br />ription of Work (addifional space provided on fhe beck): k7t PLq� �tl�e y-�j0 (,uN W� Q�%�, <br />��,Y, j(�/�j��t-T/ON 8c�t h.c�{' Colvrytacr� fe-re� <br />Have you started working wilhout a permit7 ✓YES _NO ' <br />MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br />TypoolProJect: _New_Addn _Alteration_Repair TypeolProJacl: ShoweNumber(M)o//lrfu`rest'on_Repalr <br />Show Number (N) ollixtures <br />A/r _ air handlina unils � Toilet <br />Medical Gas <br />Other. <br />I here6y cenify that I have read end examined this application and know tho same to be Irue and cortect. All provisions of lews and ordinances goveming <br />ihis type of work will be complied with whelher specified herein or nol. 7he granling of a permit does nol presume to give authority lo violate or cancel <br />ihe provision ol any other slale or Iocal law regulating conslruclion or Ihe perlormance o1 conslruction. That I am authorized by ihe ovmer of ihis property <br />to pertorm the/ w�ork lor which app'calion is made and I compty wilh ihx Stale Contractors Law 18.27 RCW and 296.200 WAC <br />�:,.c1�'� � �� �"i5 - 3 ( ^� Zb I / <br />OwnedAutharized Agont Signature Date (Revised?/201 f) <br />