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� � <br />PERMIT APPLICATIt�N <br />BUILDINGIMECHANICALIPLUMBINGIStGN/SPRINKLERIDEMOLITION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 Cedar 5t., Everett, WA 98201 425-257-8810 FAX 425-257-8857 www.everettwa.org <br />�- - iZo�Kr�� <br />lor new constivction: S�art Platl <br />— S6A N�as � <br />A�� �.ZU��S�oa�o�sov � ._C.r�o� <br />i l.. ���� (. MT C I o� No.1� (atlac� copy ol long legal tlescnpuon) <br />i4 oi t3 ZD 3 <br />NT:j�Owne� _OwneYSAgent _Conlraclor _Contractor'sAgenl _Tenanllmusiaorava�an�rercen,e-.irvu�mvo..rnr.oao..onn:r�:Pxe� <br />fRACTOR Ko� tis�. .JI`1 G <br />:z 4 (O �.Z —�8j N��.sT nJL <br />�NT BUSINESS NAME <br />LDING PERMIT APPLICATION <br />❑c a <br />o P C�iv Bus Lic. # <br />IPnonelEmail S��' � j (�$ di `- <br />CONTACTFORPERMIT 206, a�Zo-3o�� <br />Phone/E�ma�i �/�U {-VM�DA! ���-��"1�<< eG�� <br />CONTRACT PRICE OF WORK <br />ng Use o( Bwlding HEAT SOURCE�. <br />>sed Use o( Bmlding S. �. Gas� Eleclric__ Ot�er_ <br />ng type: � Single Family _ Duplex _Townhouse _ Multi•Family _ Commercial <br />ol project ,� New Addd�on Remodel Repair TJ. _ Sign _Sprinkler _Demohlion_Change of Use <br />CRIPTION OF WORK (aotl�tionai spacep�owtledon rhe �acti�): <br />►.f S u� CU�I S i 2 uC � l �� <br />MECHANICAL PERMIT APPLICATION <br />ol ProJoct: <br />_Atldn _Alteration _Repalr <br />imbcr (A) o/ liafures <br />NC — air hand6ng unds <br />Forr,ed air systems <br />hood <br />RESSION <br />PLUMBING PERMIT APPLICATION <br />o1Pro�ect: _New_Addn _Alteralion_Repair <br />Show Namberlpl o/liafures <br />O�her <br />Olher <br />sink 8 <br />Gas <br />I �ereEy cM�ly Ihat 1 �ow mad antl e�ammed iNs app¢atqn an0 knaw Ine same lo Ee truo ond carrect All pmv�s�on; ol law, ond oi��nances goveming Ihis IyCe ol work w�ll be comp5etl <br />wA� whelner specaie inn or no1 Tne granling ol a pertnn Coes np presume to give aumomy Io NOWIe m cancel ine qonsron al any oNer sla�e or lowl law regulatmy construceon <br />T�al I am autlia�n OY �� owner ol ��is pwpeny to pertortn i�e work for wNch appirtetion �s ma0e an� I wmpy wnn iba Siaie CONractors law tB 27 RLW ana 396 200A WAC `r <br />� � <br />iI�7 � �� <br />Owner/ t ized Agenl Signaturo Date (Revised 32017) <br />