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PERMIT APPLICATION <br />BUILDING/MF_CHANICALIPL UMBING/SIGN/SPRINKLER/DEMOLITIUN <br />CITY OF EVERETT PERMIT SERVICES <br />3200 Cedar Sl., Everett, WA 98201 425-257-8810 FAX 425-257-8857 www.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM 9�—I U�I Z <br />newwnstruc�ion: ShortPlatlsubdivision <br />�U N S�� �/. � � 1't1 <br />(a�tac� w{ry ol iong legal Oescn0lion) <br />L .—eo) y <br />1� vE.' � C(/i;1�GC c�ryisia�Gz�o / io <br />Owner Owner'sAgent Contractor Coniracbr'sAgent Tenantlm��.�o•o�ae.e�xrm«memnomvroo.Tawaawosmme�oxel <br />,e '�,11�'r�� n�Lr�.�l<I.'-.nl� i&ILic# N���LSN�7V�13 �COEBusLic#iT�17��9 <br />J-IL ICn"ZH ST SL <br />�Ter; y�k� 9� f���r�E�- <br />IILDING PERMIT APPLICATION <br />�`1U a" �noneiEmail ��j —`l j U— 0 �)� 2 <br />DNTACT FOR PERMIT <br />C / � L� i ,ti � I(�[0.�� � <br />ione/E-mail 7��i/1\Ch-SP(\'�i�t L�Y Hfli�l�\ <br />ing Use cf �uilding <br />�sed Use o1 Buildi�g <br />ing type: _ Single Family _ Duplez _Townhouse _ Multi-Fami/ly <br />of project New Addition Remodel Repair T.I. ! <br />CRIPTION OF WORK (addi(ional spare providetl on the back): <br />��y�j-��1� N-Zl,� Lc—t� 51l��� <br />MECHANICAL PERMfT APPLICAT <br />o1ProJecL• _New_Atltln _Altcration_Repair <br />Slmw Number !pl al (lxfures <br />air <br />Gas <br />Gas <br />Number of <br />PRICE OF WORK <br />of Use <br />UN �,� %l �r ����I . <br />PLUMBING PERMIT APPLICATI <br />of Pro�ect: _New _Addn _Alteration _Repalr <br />Show Numberlal o! lirlures <br />Roo` drain5 <br />Medical Gas <br />Other. <br />Other: <br />I Imieby cer��y I�ol l have ieatl an� enam'meE ihb app�catron en:l know;ha fame Io be Ime nn0 cortetl. M piovisiom ol lawa a�d ordeance�, go�emnp I�h yye ol worh vnll be comF���ed <br />w"4 �NtC111Ef Sp¢Cl(Rd hClQIpIX 00�. ThQ 9f81111pg OI O pPfRlil EC¢f �0� FlCSO�IIC �O Bry! BWI�OIin' Ip N0�8�8 Of CO�CEI IIIC pfOVkql1 O� BtIY ORICI SIdIP Of IOCdI4lW fC811W1i11v COOSINCB011 <br />Thal I am �mthonxed by i�e ovmerol Nb propeHy ta pertortn the work IorwTch eppfcalion b maCe anC I comph wi� tna Sia!e CoNracton law 18 27 RCW anC 248.200A WAC. <br />t-- � <br />( f'%Z� �-' ._. `�� -- -�' -��f� ' z <br />Uwner'Authotlze� Agent SlgnaWre Dale � (Revisetl 6/2071J <br />