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PERMIT APPLICATlON <br />BUILDINGIMECHANICALIPLUMBINGISIGNISPRINKLERIDEMOLITION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 Cedar St., Everett, WA 98201 425-257-8810 FAX 425-257-8857 vnvw.evere�ttwa�org' 3 <br />c.i <br />lar new cons�mclion: Shotl <br />rnx a <br />a <br />No._ (atlach copy ol long le7al descdption) <br />VNER �17� 1 '�� � Phone�E-mail � _ � � � `( '� ^1 <br />�«55 s`� Z-1 3'' t%/'L W Cty/Stale2P (= U L^1ti�� 1,�9 � cY 2�=�� <br />'PLICANT: Owner OwnersAgenl �Contracl�r _Conlractor'sAgenl _Tenanlim��ic�aheeaie;;�rc�consmioommecnrnrmao.o�n�n�.os,a�� <br />— -- n a /r <br />)NTRACTOR �{ D U N�J� �L� n� i N� State Lic. # TI� Gv r-� 1 I � ` it Bus. Lic. # <br />tlress I U �`'�� G�M�`�'�'-G��� �` ��°�� n'� Ct� ^� .1 Phone/Ema�l <br />�,NANTBUSIN[SSNAME CO��+�CR��MI� ��-J"']�J� <br />v ' ✓Z 1 t�%� c� �� � � <br />PhonelE-ma�l <br />UILDING PERMIT APPLICATION _ coNTRncr PRice oF woRK 7�3 ,.J <br />Use o( Buiiding <br />�osed Use o( 8uiltling - <br />fing type: _, Single Family _ Duplez _Townhouse _ Multi-Family __Com,�iercial <br />: of projecC New Addition _ Remodel _ Repair _ T.I. _ Sign _Sprinkler _Demolition_Change of Use <br />iCRIPTIONOFWORK(addmonaispacepro�idedonlhebar.k; � L�I�Y� I'J�nLL��Lt'� <br />, �� r'z�c.�: t , x iJ��� �' � .�•v ���' ��=�-� ���`�-�.�. _--�-- <br />�J� J��"7� ����j �� <br />MECHAPi1CAL PERMIT APPLICATION <br />of ProJecY. __New_Addn _Allcration _Repair <br />Show Numbcr (a) ol /ixfurns <br />i A�C - air handlina units <br />PLUMBING PF_RMIT APPLICATION <br />oi ProJoc�: _Now _Addn ,_Alloretlon _Repair <br />Medical <br />Other: <br />, � Number of Heads <br />I here�y mnAy t�et I have rv'sa and examineE t�is appbcahon on9 Ar.o�v the same lo be Ime and mrred All provis:ans o/ la�rs antl o�dmanW s goveming Ihi! type ol work will be compl eC <br />n�.:hwlie�herspeci�edhere�nornot T�egrenlingolapertnSdeesrat��rewn�eiog'�veau:n.rityme�o'axercanrel��5ep�c���scncla^�yet�erstaleoriocaliawregeial�ngccnstrvtlion <br />Tlmt 1 am out�ouzeC by l�a vwner ol IDis prope�y to pe�o c�w Icr �+��ch appb:=tion is maae o�C I mmF'Y �"�� �"e S::.te Coniradors Law iB Z� RCW anC 296.00A `h'AC. <br />�� � � � �� ���j�t - (Revised3/2073) <br />Owner/Aulho'rized Agent SlgnaWro Da�e <br />