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PERMIT APP�.ICATION <br />BUILDINGIMECHANICALIPLUMBINGISIGN/SPRINKLER/DEMOLITION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 Cedar St., Everett, WA 98201 425-257-6810 FAX 425-257-8857 www.everetriva.org <br />y_ �' �/ y <br />� /Y1w/�1 <br />lor ne�v con;truc0on� Short PIaL <br />7 <br />aTv rax n <br />No._ (uttac� copy of long legal descnption) <br />PhonNE-ntail <br />00 `I <br />_Owner _Ow�er'sAgenl _Conlractor _ConlractofsAgent _tenantlm�eic�c.�aoam^c�cranc�nrcen�noo.�eraeo.:n�ni�rsw��� <br />R <br />i�a�-�s � <br />BUILDIR�� ?ER <br />Use of Butlding <br />d Use ol Buildir <br />� SoJo r1 . <br />APPLICATION <br />�t' <br />State Lic # <br />PRICE OF WORK <br />City 6us. Lic. # <br />� �.J 7 Q% r%� <br />B e.%sol� <br />b.�-{, � c P�n �l to . <br />� <br />HEl�7 SOURCE�. <br />Fleclnc Olhcr <br />iing type�. _ Single Fam��y _ Duplex _To�snhouse _ IAuiti�family _ Commercial \ <br />: of projecY. New _ Addition Remodei _ Repair _ T.I. _ Sign _Sprinkler __Demolition_Change ol Use <br />iCRIPTION OF WORK (addrticnai space p�ovided on rno �ack�: <br />A��- V��t�; �a�ior� �o� Ikt�1r Sa.lor� . N e,.� �xb.0...5�- '-�-�,,✓�, <br />MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br />of ProJoct: _New _Addn ,�Alteratlon _Repalr <br />Show Numbcr (a) o/li..fums <br />A/C — air handlmg units <br />I Forced a�r svstems <br />heatcr <br />Umt <br />Number of Fieads <br />Typo ol Projoct� _New _Addn _Al�cralion _Repair <br />Show Number (M) ollixtums <br />! Totlet <br />Water <br />Grease t <br />Aledical <br />Olher <br />Other. <br />I nereCy cemly Inat I have reao an� e�am�netl tnis apC������on ana incw me sa:ne io �e lrae nnd mnen All pro��s�ons cl laws a�tl ara wnces goveming m�s IrPe ot «o�k N�n be compiieC <br />wA�x�elherspecdicd�ercinoinot TCegranlinqofapeimACaesnoteresumeloqiveaullW��lY�ovrolalecrwncelff�opr��isionoldnycl�erslaleollOGllawregulatingco�s:N<I�on <br />t��i 1 am aut�onzca Gy t�e oene� ol ��n proFerry io perfom+Ine work loi hricl� aFP��W�io� �s maCe avtl i cemp�y Hnh ��e Slate Ccnlr�pers Lan 1P 77 RCYJanC 2?6 2COA W%.0 <br />� ���►� ��2 <br />Ownor/Authorizod Agonl SfgnaWro Dale (RevrsetlY1073) <br />