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� <br />� <br />PERMIT APPLICATION <br />BUILDINGIMECHANICALIPLUMBING/SIGN/SPRINKLERIDEMOLITION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 Cedar St., Everett, WA 98201 425-257-88 �0 FAX 425-257-8857 www.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM �` O— <br />ADDRESS: q� n' I�,'I C I� V(I i� A t � J PROPERTY TAX p P T Q � D� <br />.L .W <br />lor new conslruction: Short <br />R <br />No._ (altach copy ol long legal descriplion) <br />�� U3.'� � h�u - I1�2.z <br />�r Owner Owner's�gent _CoNrador Ccntraclor'sAgent Tenanlem�+s�pm�oaeienaroiconsemrrommoc.oerioeowon�maspace� <br />S <br />� �� <br />X <br />BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK <br />Exis�ing Use of 6uilding — <br />Proposed Use of Byilding �' <br />Building lype: ��Single Family _ Duplex _Townhouse _ Multi-Family _ Commercial <br />Tvoe of proiect: _ New _, Addition Remodel Repair T.I. Sign _Sprinkler _I <br />OF WORK (adr�tional space provided on the beck): <br />1/, i <br />\% <br />MECHANICAL PERMIT APPLICATION <br />ofProjocL• _Now_Addn _Altaration ✓ Ropalr <br />AIC — <br />SYSTEM <br />Lic. # <br />of Use <br />PLUMBING PERMIT APPLICATION <br />of ProJect: _Now_Addn _Altoratlon � Ropalr <br />ShowNumber(N)ollixtures _ <br />Olher. <br />Gas <br />I hereby cemiy Nat 1 Oave read ontl e.aminetl tlis applica6on and know Ne samo to Ca true antl wned. All provisions ' laws and orCinences gavemin; t�is typa ol wo�k w�il be comp6ed <br />wnh �N�rth�. speci�ed �erein or not. T�a 9 ranling ol a pertn�t tloes not presuma 10 9ive eWhonty to v�olate a canttl Ihe provision o f any ol�er slata w laal lew regulating wnslruction <br />Tha� I am aut�orixetl by ihe oener ot t�ia peny to pehorm Ihe work lor ehich appliwtion h matle and I compry x�M I�e State Contradors L uw 1B 27 RCW enC 29G 100A N'AC. <br />���� � Z.l2.U���7 <br />OwnorlAuthorized Agont Signaturo Date (P.evised 6Q012) <br />