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PERMIT APPLICATION <br />BUILDINGIMECHANICAL/PLUMBINGISIGN/SPRINKLER/DEMOLITION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 Cedar St., Everett, WA 98201 425-257-8810 FAX 425-257-8857 www.everettwa. �r� rl Z <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM g"' <br />. . _ oonncnrvrnitn PERMITp <br />�I `l U 1 S� �.,..., <br />tOffICwCOnSINCIi001 $hOh <br />� Owner _ Owner's �genl <br />LC <br />No, � (altach wpy ol long legal desc�piion) <br />_ T 1 _ i. � . I _ _ / � . <br />2_. <br />Conlrac�or _Contractar'sAoent _Tenanl�m�nio�.aear^oroicrosemrto�c.e.T•�iomwo•�mme.�acel <br />BUILDING PERMIT APPLICATION <br />PRICE OF WORK <br />:xisling Use of Building � <br />�roposed Use of Building Gas <br />3uilding lype: _ Single Family _ Duplez _Townhouse _ Multi-Family _ Commercial <br />-ype of project New _ AddiUon Remodel Repair _ T.L _ Sign ^Sprinkler _De <br />)ESCRIPTION OF WORK (additirna� spa:e provided on the oactil: <br />�'4' tt-� r�`�;� �-e ' ( -14„ N�,,,� �;, <br />� r���`�e ;n ��er o'7 <br />����h�, ��,1.� � li��, N bc�ck w��<< s< ,�.� p�., ;V„1 �:�c- <br />P <br />PERMITAPPLICATION II PLU <br />oiProJect: _New_Addn _Allcration_Repair <br />Show Nurnber (p) ol fixfures <br />1 AIC - air handlino unils <br />COE Bus. Lic. # <br />�-a�1�1�c�S�-1`, <br />HEATSOURCE: <br />_ Electric_ Ot�er_ <br />nolition_Change of U. <br />'fht _i�dS. <br />��c �3 C�� _ <br />tMIT APPLICATI <br />ol ProJecl: _New _Addn _Alleralion _Repair <br />Other. <br />Gas <br />I hemby ocrtity Ihal l hova matl on� exuminetl m�s applKatan ond know ��e same to Ge Ima and ccrtec� ��0 prmisiom ol lmn enE ortlinoncef govemn0 �hla p'po al�w�k mA be complieJ <br />v; nii �v}�,ellmr speci(roC herein r noL The Orantinp ol a pemiil Coef nol presume to S'�e nul�onry m vioiaw m cancel Na pmWsbn ol any ot�er slaie or local law reBualinp conshvction <br />R�al I am oWhoiima �y Iho ovme� Nis��perty to pedortn Tn wod lonv�k� appl�calbn i> made onC I compy wIh t�a Steto ConVatlon Law 1827 RC\V anC 298 200A WAC. <br />.G� � '� ��`� ` �.i /Z- <br />' Owncr�Llfiodzed genl SKjwlure ale (Revised 6/2011) <br />