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�ERMIT APPLICATIO� <br />BUILDING/MECHANICAL/PLIJtiIBINGfSIGN/SPRINKLERIDEMOLITION <br />CITY OF EVERETT PERMIT SERVIG�S <br />3200 Cedar St., Everett, WA 98201 425-257-8810 FAX 425-257-8857 vn+nv.everethva ora <br />JDRESS' IPROPFRTYTAKN <br />04 4+!� AJ� 5� �zJVLraT <br />IorneNWnstmclan: ShorlPlaVsu�a�vi5lonlLl���d�L. {AQ..� Lo1NoC <br />R `�c arr LC'z. <br />(alldCh copy ol ICng legal tlescnot�on) <br />�r S 3 - Z�•oo <br />12oSw %J4RruT w�ta�w��s i�oo �caYrsi�ieiz�p�r��,E.i�- �,�q.. 9�32oq <br />ANT:__Uvner __Gvner'sAgert _Com�acto� _Contraclo�sAgrnl _Tmont;+,.vm.+bar•�.�xv„>a�i!m:na.n,.uoo.:.i„Tesp,r„i <br />C'C <br />BUILDING PERMIT APPLICATION <br />V Crty Bus. Lic. #(p3-24ld}�71p0 <br />"nonC�Ema�l <br />C(JNTACT FOR PERMIT ��NN ����.Q <br />Pnone�6mad(4Z5 ) 3so - 4c�oz <br />CONTRACT PRICE OF WORK <br />F€isting Use of Bwitling _ � HEAT SOURCE. <br />PwDosed Use ol pwiding Gas � Eler.lnc <br />BuJdmg type: � Single Fam�ly _ Duplex _Townhouse _ IdWti�Famdy _ Commerual <br />T��e of pro;ect ✓ Netv Addit�on Remotlel Repair _ TJ ^ Sign _Sprinkler Demo!�hor. Chang� <br />DESCRIPTION OF WORK (aa��;unei space c���deo on rne Dnck) �. <br />Z Zo 3+? �, Z c/�2. c, raru�c�� <br />MECHANICAL PERMIT APPLICATION <br />o! proJocl: <br />_AUdn _Altaratlon_Rapair <br />s <br />— air <br />i <br />WOOd5IDV0 <br />ol <br />�C3 As \ L> <br />PLUMBING <br />KB�yo3-oog <br />_Addn _Aliorapon _ Rapair <br />�mber (N) ol lixiures <br />Other <br />Othzr <br />I �ercbr ce�1y t�el 1 �om reed and eaamma�l �rt; xpp�m�un xn� know Ine fame lo Ee Irue and rnrtnct AO qonsiona al ln�s anE arC�nances govem�ng I�i3 t�pe ol wwR wS Oe comped <br />w;n w1e1Mr specCmd nrrcm a� nCt lTa prardm; d e pemN �bel nvl powmo Io qNe a:nMrtly ID rbiale a vncel ine prov�sqn W 2ny otner slale w bCal Nw rtgu!aing croswnon <br />IDatlam otbo' tl0yth_I�wnoro/tn'. p•oDW��PMorml�e�wrtlorwhiNapp?r�IbnifmaEennOica��Nywl�t�e51a'eCor.Indorsla.�1827RCWonE.9G2WAW,1G <br />C/ <br />�'_ �-z�- �� '�z <br />0 r/AulhorizotlAgont5l n�turo Dale � (Rmaseo3ROfJ) <br />