Laserfiche WebLink
S/�l�t Il - �'�-3 <br />S(.-7�A 1.�-o/i <br />PERMIT APPLICATION <br />BUILDINGIMECHANICALIPLUMBING/SIGN/SPRi�IKLER/QEMOLITION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 Cedar St., Everett, WA 98201 - 425-257-8810 - FAX 425-257-8857 - www.everettwa.org y�_" <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM F" <br />ADDRESS: PHOPERTYTAX7t PERMITN �� <br />7 0o Zo �fC . Sr,eFe �- 00 56 32 / oa /Oo <br />lor new construclion: Shoh <br />33o3r'o <br />A 7d' T Mo3i� irY <br />PERMIT APPLICA.TION <br />Lol No._ (atteU copy ot long legal descnp4on) <br />�onrlE-ma � 3(oD • 70 9•$ Z Z 9 64II �✓rIp[d < <br />ty:State2ip �E��Lf, (ic(�G 9 8 ( 33 <br />&ILic.# <br />PhoneJEmail <br />ONTACT FOR PERMIT�pK M��KL�ct <br />Z O� •384 2454 'I <br />nonelE-mail f'py�eC F�EY � �aw <br />oNTRACT PRICE OP WORK <br />UseofBuilding 7YU1 �"IGtI��E''TaKce T�'�'•'•'yn�== <br />d Use of Building 5�%7E <br />Other <br />Building rype: _ Single Family _ Duplex _Townhouse _ Multi-Family � Commercial <br />Type o( proiecC _ New _Addilion _ Remodel _ Repair�T.i. _ Sign _Sprinkler _Demolition_Change o( Use <br />DescriptionofWork(additionalspacepmvitleAonfhebach): Moj�(F`/ �X/ST�KG ��I�iT/N(� (lN�iTAFFE� <br />�,,iKece9s Conr�uK�ca� �o,v faC�trry w�rH A�D�na� oF �1d,E66 C!% ��4^«L <br />AKrEKKAs, S�x(6> REnorE R.�aro yeaDS �uD o�vr�r� S�RGE /�.2o7�CTo7e <br />Nave you started working without a pertnit7 _YES %� NO �DUE R� <br />MECHANICAL PERMIT APPLICATION <br />afProjecl: _New_Addn _Alteralion_Repair <br />Show Number (#1 0/ fixtures <br />SPRlNKLER! <br />Heads <br />PLUMBING PERMIT APPLICATION <br />ofProjrr.t: _New_Addn _Alteration_Repair <br />show Mumber l#) ol fixtures _ <br />Mediwl <br />Olher: <br />Olhec <br />I here6y certiN'��at I have reatl antl examined this apphcalion and know Ihe same to be lme and wrrect All provisions of laws and ortlinances goveming <br />this type of wnrk vnll be complietl vnth whether specified herein or not The granUng of a permii dces nol presume to give aulhoriry to vlolate or cancel <br />tne pmv�sion ut any other state or local law regulating wnstmction or lhe peAormance of wnstmctian That I am authonzed hy the ovmer of lhis pmperty <br />to pedoim the wnrk �o� which apphcahon is made and I wmply with the State Contractors Law 18.:7 RCW and 296200 WAC <br />��_ /_� ���� 7� 22 Z O// <br />�O'�%u�Nt (Revised711077) <br />OwnerlAu�horized Agenl Signalure ���e <br />I/� <br />