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� � <br />PERMIT APPLICATION <br />BUILDING/MECHAN4CAL/PLUMBING/SIGN/SPRINKLER/DEMOLITfON <br />CITY OF EVERETT PERMIT SERVICES <br />3200 Cedar SI ,[verett. WA 98201 - 425-257-8810 - FAX 425-257-8857 - rn�nv.r_vcretnva org <br />APPLICATIONS ARE ACCEATED FROM 8 AM TO a PM � 3O`"� � <br />SITE ADDRE55: vflOOEaiv inx u PER1d1T C <br />�nn �.2 �l ��Q,�i% lei 2a 042'� (701 O11 0o G17 UZ-00� <br />LEGAL for new coos:mclron SncA Piat%s�Ca vsror <br />OWNER /�-U/�,�/L� � ✓ui�75�i✓//�/L% /GBG�/ <br />�ddrr.cs ��(�� /C(XJSG�G� ��Q� <br />CONTRACTOR OGII��IL <br />A�tlrc55 <br />7�r1% <br />BUILDING PERMIT APPLICATION <br />_, c,; Cc __ (aitaen ccpy o� io�q '�egal dnsa�,t�_n� <br />F'tcrc�� ^�a�l %�-S/y <br />� L7 <br />I Lic # <br />IPhrne;Finail <br />TACT FOR PERMIT IL�()�./ <br />�,;_ m, � /��4r,e/071 fir�C. � �1 ZGL�J <br />TRACT PRICE OF WORK 7_SOOO <br />ilIG1 <br />Laisbng Use d fim''d�rr. K�!���% __ _._ HFAT SGUP.CG <br />Prcoosetl Use ol 6��'tlirg � /�L'I __S�'I "� _ Oas �[;eUr.s_ Ci'•r.er_ _ <br />13���qing lype. _ Single Famdy __. D�cle�r —Townho�s _ Mulli-Fam��iy� _ Comm=rcal ��/ <br />Type o! prqect _ New , ACci;��cn _✓ Fiemcde! �epair _ T I ✓S�gn _Spnnalel ' Demoht�on VC!�ang= of Use <br />UeScriplionot�':o•klac�nnr.alspacewcv�Cetica!'�eCacwJ g,�� ��� ����� �� ������ <br />�� .Y�'!�i it/.!%ui � �� ; . <br />Nave you started wurking without a permit7 __YES _'� NO C,�� ,r}%�Z�K- �� /7U�/���/ ��� <br />MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br />ol P�ojccC _New_AAQn _Altcrallon __Repair <br />Show Numbcr (p) o/ lutwes <br />� � AIG - av handling units <br />�T Farced air svstems <br />hezler <br />FMhBuSt <br />Urd healer <br />SPRINKLERI <br />Nu�iCcr o! Neads <br />ON SYSTEM <br />ol Projecl'. _New _ `Adtln _Alleratior __Repah <br />$�Ow NumbCr(Nl ol (ufurc5 <br />ToilCt <br />)� ' ' Balht�b <br />� Ila✓atory (wash ba5m) <br />Shower <br />• � Knchen s�nk 8 tlisposal <br />, Dishwasher <br />' Ciothes washer <br />Waler heater <br />Sink (servicelbar/mopletc ) <br />Back(low preventer <br />Uunai <br />Dnnking Founla�n <br />Floor dra�n <br />� Greasc trap <br />Roof tlrams <br />Metl�cai Gas <br />Other. <br />Other <br />� he�e0y ceitity �hal I have rea0 anC Cxamme0 ;�ns apphwtion and know the same to Oe We and corred All provisions ol laws and ordinances govern�ng <br />Ihis lype ol work wJl Oe [ompDeO wdh whMher speofe0 �erem or not The granUng ol a permi� tloe5 nol preSumC lo giVe Bulhonly to vi0lBte or CanCel <br />the prov�swn ol any olher slale or lawi law iegulatin tonsWtlion or Ihe peAormance of constmcLon. Thal I am aulhonteo �71he owne� ol thu oropeity <br />tn �r'orm Ihe work lor w�ich appliwlion is madr. and I comply wilh ihe State Conlracto�s Law 18 27 RCW and 296 200 VJAC �� <br />�ih�r�/ //J°�� a- �s. a o�� <br />�ar ulhorized Agent Signalure Oale (Rem5etl7�:011) <br />