Laserfiche WebLink
�ERMIT APPLICATI� <br />BUILDING/MECHANICALIPLUMBINGISIGN/SPRI(�KI.E�IDEMOLITION <br />CITY OF �VERETT PERMIT SERVICES <br />3200 Cedar St., [varett, WA 98201 425 257-8810 FAX 425-257-8857 www.everettwa.org / <br />y��o-�S <br />4DDRESS: PROPERTV TAX p PERMIT fi <br />'- . � .�.� —, —� ._i i n .. � � J�A IF/�.�, n�n� <br />lor new canslmcLon. Shorl <br />No _ (atlach copy ol long Icgal descripbon) <br />ER � V C �t � Phon�/E-mail <br />;s � �`L�G� %�t%% �v[, �7 "lL CnyiStace2v � J-C f C � �'V F?— l'l �70g _ <br />.ICANT:_O.vner _Ocmer'sA9en1 _Conlractor _ComraUo�'sAgeni _TenanitR,siv�a+aoo�r.ie�mco�;uoirtem�nea.,,c�neowcni.,�eei�a;e� <br />fRACTOR ��C� �W1 �� V�}-[_ State Lic #!�-r�Oh'1 �� 'rjZUti(.�Y Bus. Lic # Osy� <br />ss �"f 7 Z 5� L�ol 1� G� ODU� lN / H �� Phone/Ema�l G� Z_ J �/� S �— _. <br />BUILDING PERMIT APPLICATION <br />PRICE OF WORK <br />/Gl✓] � /rv. Cl /Yt <br />Exisung Use o( Budd�ng , � HEAT SOURCE. <br />Proposed Use of audding _ Gas V Eiectr�c_ Ome <br />Buddmg !ype�. _ Single Fzm�ly _ �uplex _Tovrnhouse _ Multi�Pamily __ Commerc�al <br />1'yoe of projecf Nev+ __ Add�hon Remotlel __ Reoa�r _ TJ. _ Sign _ Spnnkler _Demoliuon_Cnange ol <br />DESCRIPTION rJF WORK (addrt�ona� space prov�aed on rne back) � <br />�'�� �l«T n✓� tn- �'U �KlsTihS �vrn�.�L <br />TypeolProject _New_Atldn _Al(eralion_Repair <br />.i�ow Numbcr (p) ollixtures <br />�—A/C - air handhnq unus <br />D <br />I SUPPI <br />Number of <br />iype of Project: _Now _Addn _Alloration _Repa'�� <br />ShowNumCerlpl o.`/ixtures <br />Other <br />Other <br />sink <br />healer <br />ains <br />I �eie�y cetlAy I�dl I havC rca7 anC mlmined Ihis oppCGition anC know Ihe sdme lo Oe Irue anC mnetl All pmvisions ol laws anE o�dinances govermng IMs lype ol �vork will be compCe� <br />vnl� wAelOer sDeciLed �ereln or nol The yanting ol a permil tloes nol Olesume to grve aulnonty lo violale or wncrl iqe provision of any oIDer slate or local Invi reguiabng conslN:lion <br />T�at I am aul0anze4 Oy IOe owner o11M; D�opetly lo Fedorm the xrotk /or wh¢h a00!'�alion is made and I comply with Ihe S�a1e CJMractors La�+ 18 27 RCW and'196 2COA WFC <br />�1.�� �/�// � <br />O er Au aed Agent Signaturc i Daie (Revisetl �2015) <br />