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06/29/�O1^ PRI 10:1! F.lx a�5 4P� 452a NortcreeY. Roofing <br />pao=ioo3 <br />PERMIT APPLICATION <br />Bi11LDINGIMECHANICALIPLUMBING/SIGN/SPRINKLERIDEMOLITION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 Cedar SI.. Everelt, WA 98201 425-257-9810 FAX 425-257-6857 w�nav.everettvra.org <br />APPLICATIONS ARE ACGEPTED FROM 8 AM TO 4 PM <br />TEAD�RESS: PROPERTVTAXp PERI�11TI1�o^ ,�l,l <br />\\�\O .'� P \ C�E _ \�\ �� � (x/ <br />lornewu:nslmcliort Sho!� <br />No._ (altaU copy ol long <br />�es���G��o�� <br />� <br />Owner Owner'sAgen� Contraeicr Co�lracwr'sAgent Tenant��mio�o.:eeaic•uaa�umrtenmr���-,r��oao��.+��•irt�ns:,:<� <br />m f�\...->-�. (� �..oe�[ �nr��-. n n L 3 I Lic. iJ �IiGI ��9R ' U i7 COE BUS. Lic. #��a�� <br />LDING PERMIT APPLICATION <br />PRICE OF WORK <br />ing Use of 6uilding HEAT SOURCE: <br />�sed Use of duilding Gas___ Fleclnc„__ � <br />inqtype SingleFamily _Duplex_Tmvnhouse _Multi�Family _Commercial <br />ol prqect New Addition� Reinodel Reoair T.L Sian Snrinkler Demolition Changc <br />CRIPTIONOFWORK(adUdionalsOo�epmvidedonfne ack): , , <br />ieo.r- o�s �- lay��,� o� Lom�os���a,� �. rL�1aLe <br />C� rr. � 0.S i'�''� c.� . <br />MECHANICAL PERMIT /..PPLICATION PLUMBING PERMIT APPLi: <br />Use <br />�u��h <br />ofPrqech _New_Adrin _Altoration_Rnpalr TypeolProjetC _Now_Addn _Alloratlon_Ropalr <br />u <br />nro <br />fan <br />Numt�er ot Heatls <br />units <br />Shower <br />KrtGien sink <br />hledical Gas <br />OUiec <br />ON <br />I neia:�y ceni'y Inbl i have �es� an:1 e�nnuneJ i��s appbcaiian ana Anow I�u samo m Oe ime and cortttt. AI prorlabns of Wws ana ordlnances poveming Oils type ot wmk ws Oo wmp��c:] <br />�v+n wl�.elner specAKE Iferen cr nol. ine gramio� cl a peimn Uoes not presume la 9ive aut�ority lo vq!ale or tancel lhe D�ovisien ol any ol�cr tlole or Ucal IBw fepulaling conslmUrvn <br />1 n:,l I am autnc�CeJ by tne cwner ol �his proDerry m peMrm I�e wo� lor w�i;t� appbcm;en Is moCe an01 campy w�i� ��e Siale Conva:iors Law 18.27 RC W mC 200.: WA IVAC. <br />l�ll.lVi�� �LI111 ���a�"1—►� <br />OwncrlAuthorized Agenl Signature � Drdr <br />� RP� �Setl d : i, i:) <br />