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�/-� �°�-'/�'1�`�� ���3 <br />PERMIT APPLICATION <br />BUILDING/MECHANICAL/PLUMBING/SIGNISPRINKLERlDEMOLITION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 Cedar St., Everett, WA 98201 425-257-8810 FAX 425-257-8857 �w✓w everettwa.org <br />a � ��-�� <br />4DDRESS: PROPERTY TA%p PERMIi # <br />-7�c.L ��1, .�I)l,zaavv ll,0,�1 :� �.O�yD�-n3( <br />for new conslrucUon� Shon PlaVsuGdivision Lot No _(atta[h copy of long legal desaiplion) <br />_Uwner _Owner'sAgent �[CoNraclor _ConlraclofsAgent _Tenam�a�us�cr�„co�m��•:mcoos�muo��noe+:+e�:�eo..n���^.osP�w� <br />Lic <br />ING PERMIT dPPLICATION <br />PRICE OF WORK <br />Use of Bwldmg <br />d Use of Bultding�tln/�/ <br />type: _ Single Family _ Duplex _Tovmhouse _ Mulli-Family _ Commercial <br />�roiecr New Adddion Remodel fteoair T.I. Siqn Sprinklei <br />��nv��/ , <br />UJ <br />HEATSOURCE. <br />_ Eleclric_ Olher <br />oiition Change of I <br />DESCRIPTION OF WORK ladmr�onai scac`prorirled on the back) . <br />`�G�en���� �o�Z �Q�v� � L�ti� <br />MECHANICAL PERMIT APPLICATION <br />ol Project: _New _Addn _Allcration _Repair <br />��t, — air na <br />forced air s <br />Gas piping <br />Water heate <br />Gas freplac <br />Gas rangc <br />Clothes dryi <br />Range hooc <br />Eahaust(an <br />Heat pump <br />Und heater <br />SPRINKLER I SUPPRESSION SYSTEM <br />Number of Heads <br />PLUMBING PERMIT APPLICATIOW <br />of Projact: _New _Addn _Alleration _Repair <br />Show NumberlRl of /irfures <br />ink <br />Medical Gas <br />Other <br />I heieby ce�Ay Ihat I have ieaC and e�ammed Ih.�s app6wtia� antl lnow Ihe same to �e tme and conect All prrn�ismns ol �axs. nd orcnances go�em�.ng t�as �ype el norf x�� I �e compLed <br />wdn w�e��er speci�ed Oerem or nol T�e gi0r.png ol a pertnl Gaes rel F:nSmrNo gn�e aNhonly lo vrolale or carttl t�e pim'ision ol any alher slale ol loGal law tegulaDn9 ca-.sWcben <br />tlial I ar�by t�1e owncr ol I prefe�y lo pertortn I�c �corA Im w�¢� apPlieiti-o �a made an� 1 cempiy �v^,h mc State Contractors law td Z7 RC W antl 2?6 2C04 L44C <br />� 7�n-- 2 -1 � <br />OwnorlActhoriz Agent Slgnaturo Uale � (Ro�vsed 1?013) <br />