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�� <br />PERMIT APPLICATION <br />BUILQINGIMECHANICALlPLUMBINGI�IGNISPRINKLERIDEMOLITION <br />CITY OF EVERET7 PERMIT SERVICES <br />3200 Cedar SL, Everett, WA 98201 425-257-8810 FAX 425-257-8857 vrww.everettv�a.org <br />�,+ <br />lor new ccnsimclion: Shod <br />� <br />TA]( # <br />PERh71T <br />i�_ � <br />�qILIL �o�rya.L� !aitachcopyollanglcga�descriplionj <br />L L ��t53-Z'�oc� <br />rno�efe-mad 4z7 <br />i0�i1%�L.Q-.E� b�%P.. Q`�Za. <br />ZO S�.0 tLV -[i`-i-�� �..-.... -..--- - <br />4NT: Ov+r.er _Owner'sAgent _CoNractor _CaNractofsAgent _Tenantt�»�++p�+eeaieneraf�o-.ee-�t„Jmw:+rr�>aa.cn,ne.os�aco) <br />�L� �A�� .-� C� Slate lic ���-��'�`OOS$U Ciry Ous. Lic. # � -�� �O� <br />4CTOR �� <br />S.p�`� Phcne�Ema�l SPv�Fc.-. <br />f BLISINE55 NAME CONTACT FOR PERMIT S��N �{L,� W: <br />^'---,� m,,, �-iZs� 3S � ' ��tiL <br />UILDING PERMIT APPLICATION <br />PRICE OF WORK <br />isUng Use of 8udding � <br />oposed Use of 6utlCing <br />uloing lype: �Single Famiiy _ Duplex _Townhouse _ Multi-Famdy ___ Commercial <br />oe of pro�ecl � Nev Addiiivn Remodel Repair _ T.�. _ 9on _Sprinklei <br />ESCRIPTION OF W ORK (acd no�ai sp.�ce pro�ided on tne bocx) : <br />(lOGo Z- c-,a2 �ia.2��,� <br />MECHANIGAL PERMIT APPLICATION <br />ol Pro�ucl: _Naw _odC^ _Allcralion _Repair <br />Hc�i <br />Other <br />�?>P�S : C�, <br />HEAT <br />✓ ��. <br />Use <br />�/3 I `�0 3-OOfD <br />PLUMBING PERM17 APPLICATI <br />ol ProJOc�: ✓Now _Addn _Allora[lon _,kopalr <br />SnowNumhcrlM)o!lirfu�s _ _ <br />Kitchen <br />i Other. <br />.__ � .,��....� <br />1 hereby a:Lty I�at I �avc imd arA cuun��c0 Nis apDir-�x'^ i^d kna« lhe same lo be lme end mrteq. A7 provlsions o� laws anC ord�.nances govemm9 ���s Irpe cl Mntlew+i Ec wmplied <br />Nnn w�Nner speclM heren tt ��. ��e 9�^U^P a� � 7�^^h dces ncl p�esmne lo qive vm�Nay io Hola�e c� cancei lhn ryonswn cl mY �nM �ll!o oi locel �m� mgul�!mp cor.ttudron <br />iMl I nm �.nh ¢r!//dd//� Re n oft�n p:nperfy �o pMam t�e.rork br whlN appl�wt�cn Is m:fEe nna i cnmp!� xr.� nw Slale LonVacmo Law 1B 2] RG W anE 298?OOA IVAC. <br />�//////// '1 ��Z <br />����_ � ` ;Rev�s�d3�10f31 <br />Owi r Authorizod Agont Signaluro Dale <br />