Laserfiche WebLink
� � <br />PERMIT APPLI�AYION <br />BUILD�NGlMECHANICALIPLUMBINGISIGN/SPRIlVKLER/DEMOLITION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 Cedar St., Everett, WA 98201 425-257-8810 FAX 425-257-8857 www.everetlwa.org <br />ST� <br />lor new constmclion: S�ori Plal/subdivision� x�a�• <br />a S�t�crt�'i. P�c�.F�c t��ann,kS <br />12n 5�,.� ���.e�tT ww-ww� <br />RTY TAIf p <br />No. 3 (allach copy ol long legal desaipiion) <br />,� �4za )9s3 �Zao� <br />. �t8z-o4 <br />_Owner _Owner'SAgenl _Conlraclor _CoNractofSAgent _Tenantl�siv��aoaioeerc�wnsom��wnmowne�maowon�nmosw:ol <br />l� <br />BUILDING PERMIT APPL{CATION <br />eus ��c. tM�3 -Z1¢Q <br />�Phone�Email � � <br />)NTACT FOR PERMIT <br />Sot+a Gv.►�t'--�d <br />one/E-mad < <E�S) 3So- �.00z <br />PRICE OF WORK <br />Use ot Building HEAT SOURCE: <br />d Use of Building _ Gas � Electnc__ � <br />rype:'✓ Siagle FamJy _ Duplez _TrNnhouse _ Multi�F.�mily _ Commercial <br />srojecL ✓ New _ Adddion Remcdel _ Repair _ T.I. _ Sign _Sprinkler Demolition_Changf <br />,IPTION OF WORK (edddiona� space proviCed on rne Dack): <br />Z zo 3 4�-�, z c� �.�vi..�,� <br />MECHANICAL PERMIT APPLICATION � <br />01 Pro�eck `! New_Addn _Attaratlon _Repalr <br />[�y i <br />Ka � `�0 3-0o g <br />PLUMBING F FRMIT APPLICATION <br />o1ProJuct:✓New_Addn _Alteration_Repafr <br />Show NumberlMl ol fiYfures <br />.^-. � Medical Gas <br />� Other <br />� Other. <br />I here0y �e�dy I�al I �ove reaC anE e.aminec Ihis appl�wlion and know �he sama ta Ec irue antl wirecl. All provisians ol laws and oMinan[es goveming I�IS type 01 work vnll be comp!ieE <br />wil� whelher speciGeO �ereinor nol T�e granling ol a pertnA Coes nol oiesvma to give aul��nty loviolate or Cancel l�e provision ol any ol�er slate or Iocal law regulating conslrvtlion <br />That I am ut� rine �� ownei ol �Ms property ta perform Ino worA for whic0 appl:wiion Is maCe anC I wmply Hr� t�e S�aro Lonvatlors law 18 27 RCW an0 296 200A WAC. ,/ <br />�v <br />� <br />q-za-i�{ <br />Ow rlAuthorized A9en1 Signature Dale (Revised 7R013) <br />