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❑ <br />� <br />PERMIT APPLICATION <br />BUILDING/MECHANICALIPLUMBING/SIGN/SPRINKLERIDEMOLITION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 Cedar St., Everett, WA 98201 425-257-8810 FAX 425-257-8857 www.everettwa.org <br />� —o�—�v <br />OPERTY <br />S <br />r: <br />br new conslruction�. Short Platlsuhdiviswr. LoI No._ (attach copy of Iong legal descriplionJ <br />�r�C� �� S� 1T"� �lA ) ICilylStalelZip � ��/f'!� n ,� ����j <br />_Owr.er _O�vner'sAgenl _Contrador �Conlraclor's�genl _Tenanl(m���Uro�eo.,i�ne�o+cc�:�mirommcow�enoao«aammosoacel <br />Lic # <br />S <br />Bus. Lic. # <br />BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK /�/nV <br />Fxisting Use of Builtlmg H[AT SOURCE: <br />'roposed Use of Building _ Gas___._ �iecinc_ Omer_ <br />Budding lype. _ Single Family _ Duplex _Townhouse _ Multi�Family _ Commercial <br />iype of pro�ect: New Adddion Remodel _ Repair _ T.I. _ Sign __ Sprinkler __Demolilion__ Change of Use <br />DESCRIPTION OF WORK (adddional space provide� on the backl � <br />G�,�.��Q ��� -�' i- �;- .e.��� cwZ. , t2.c�-L , I,c� ti,-f Ql f% ea-`� <br />� <br />MECHANICAL PERMIT APPLICATION <br />Type of Project: �New _Addn _Alleratian _Repair <br />Show Number(qJ o!lixfures <br />a <br />ON <br />Numberolfieads <br />PLUMBING PERMIT APPLICATION <br />of Projecl: _New _Addn _Allemtion _Repair <br />Show Num6erlN) ol lixfures <br />Kilchen sink 8 c <br />Uishwasher <br />Clothes washer <br />Water healer <br />Sink (servicelba <br />6acktlow prevei <br />Urinal <br />Drinking Founta <br />Floor diain <br />Greasc Irap <br />Roo( drains <br />Medlcal Gas <br />Other <br />Olher: <br />I �e�eby CeitAy ihal l have teaA antl e+amined Ihis app!iwl�on and tnovi Ihr Samr. to Le bue and r.oimcl MI pruvr,ion, nl I:�vr, and nNmance�; 9ovcimng Ihis lype olv�ork vn�l be comph^d <br />wnh vd�elher :petdea Oerein or nol ��u qianlin� �f a pennil tla�r qol p�esume l0 9ne avllim�ly 10 molale oi cancel l�e p�ovizion oi any olhe� slale oi local law rcqvlatin9 construdlon <br />ihai I am au ontetl Ly Ihl Ocmef ol l�rs proVetly lo pertonn �pe wotk foi wN[� �pph[, tion I5 matle antl I comply vnili Ihe S�ale CnNrdUo�. Law iB 77 HCVJ antl 796 700A WAC <br />, ( �/ � a <br />0 rized Agen ign�ture D IC (f7r.viseA]/201J) <br />