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PERMIT APPLICATION <br />BUILDING/MECHANICAL/PLUMBING/SIGN/SPRINKLER/DEMOLITION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 Ce.iar St , Everett, WA 98201 425-257-8810 FAX 425-257-8857 �•n•nv everc(h:�a org <br />ADDRE55: <br />lor nc�v mnstrv.hon Short Fla'Jsu6aivi <br />� t�l�c�. �a�, �LL <br />5�41 �� _ ,�+ Sf <br />�• <br />PE <br />Loi'Jo latlach cn.� el locq lega'. Cesu o:'crl <br />Phon.•�E�riai =�2�1'��V—i�(� <br />�J ���,������Z�o ,�uKa�� a �,/A. �i�z� s <br />NT: Or,ne� �Cwne�'sPgent _cCor„rac'o� CordracloisAgent _ Tenzn;�-��ar-,a�a�e•.�;�:.-ne-•.r:z_:.,..-«:�,�,r,w.cn.rra:n=r <br />�roa C-rol �1,1�or L� �., +. l,� , si,i� � � a c�iY ��5 ��� a <br />�/"1 1-) �C-� l� �� 51\ G' JU(� P�o^eFinail ��S �� 3L- �Q��y .. <br />UIL�ING P�RMIT AFPLICATION <br />TACT FOR PERMIT � '' S I�� �„� <br />�� �-�,s L ��v, r <br />�iL�ma� %(Z�'23���C�� <br />TRACT PRICE OF WORK _ <br />[xisurg Usc o! Bwla!^.g S r ____ HFAT SOURC[ <br />Prcpeted Use o(l3wld��ng_ __ aG�?' �' �� Gas _ Eieunq) _ <br />Bw'tlmg type � S�.ng'a Fam��y _ ��plex _Tov.��ulli-Famdy _ Gcm�reraal <br />Type o' pro�etl Ne.�� �ldddicn RemoCel Repa�• T I Sinn _ Spor4'er f.c:no�iLon_ Chan� <br />DESCRIPTIONOFWORK��caar��i.sc�-ccr�c�ced<�me;:;ic�: � <br />1 i� �n � �{-✓'✓�G� rut, <br />MECHANICAL PERMIT APPLICATION <br />7ypo ot Proloc4 _New _Addn _Ntcratfon __Ropalr <br />SP <br />A�C - du !�ar <br />Farced a�r sy <br />Gas pip;ng <br />Water healer <br />Gas Greplace <br />Gas range <br />Clothes dryei <br />fianqC hoUd <br />E�haosi fdn <br />Otner <br />RISUPPRESS <br />Number o! 1{»as <br />Gther <br />o' Usc <br />PLUMBING PERMIT APPLICATION <br />Typo ol Pro�ocl: _Now __ AtlCn _Allcratlon _Repair <br />Show Number,tl) ol G+fines <br />smk & <br />hCf <br />i Flocrtlram <br />Groase Irap <br />Rao` drains <br />t.tedral Gas <br />� Other <br />; other <br />I'�c�r:/ �rr�tp I�a� � �a..e �ead.rJ e..�^..�e: �P�; a�;'.�„a! e��.�..1 �-o.. iL•• s,r-.e:o �e Vve �mE ceirecl FI� pmavon; al Idns :^ 1 o�C�fances govem�ng Ihis lype nl work x:'I �e CpmpliCE <br />w'9.hcl4ttsMUir40eic�nerncl iney�.nLngc'JocT'ta'vrs^::r'�•sdi^crog��e.u'�entylorolTe4i4rcellnopc.miona7.ID�o'nerslaleGIJWllawtegulatingcCnsWCUen <br />,� I+n 3Nne�4eC CY ��e ohner c ��� propeny la perto�m i^e x0A Iw w9�q� apP"whon �s maee an� I tom��y N�;A •he S:a1e Ccmra^;n Law f B i] hf,�V an] :95 700.A 1YAC <br />1Z <br />, % %- 3�-/y �' <br />Owno uthorizedAgentSignatum Da'r IFe�rsed.i4��?' <br />