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PERMIT APPLICATION <br />BUILDING/MECHANlCALIPLUMBING/SIGNISPRINKLER/DEMOLITION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 Cedar St., Everett, Vl'A 98201 425-257-8810 FAX 425-257-8857 www.everettwa.org <br />ApPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM �'I " 8- — � 3_ <br />PERMIT II <br />lorner+consimction: Short <br />t �to��a �'o �h p;2.vc <br />�Gl'3< <K'r� <br />iucC z <br />:ej� <br />Lol No. %'L (at�ach copy of long legal description) <br />Phone�Email YT� 3�6�'lY%G WrN�r �I,56 ��•.�c'cs� <br />_Owner _Owner'sAgenl �CoMractor ConiractorsAgen� _TenaM(m•�s�pronae�iee�ro�ccnsem�mmmoow�mioaowoxbmospaw) <br />J C�GP-�� (.:. / ��f C <br />�PK ri/ 11; : i!. ,'�-..l <br />\ <br />ro55Gr�ee.IC (�,��f'v�:�c:fic-H, <br />& I LiC. <br />LdI�C <br />Phone/Email <br />e,�•�Kc �f�S 37v <br /># UD:;CC`N D <br />SC;d:keo��' ;,•c,;u• <br />� a'Gt��(. �:t <br />BUILDING PERMlT APPLICATION CONTRACT PRICE OF WORK �� +�' <br />Exisling Use of Building ��C- � ur �v lLFS�� Zivi P_ <br />HEATSOURCE: <br />Proposed Use of Building ' v � w� � � ���"'� �� Gas_ Eiectric � Other_ <br />Building type: V Single Family _ Duplex To nhouse _ Multi-family _ Commercial <br />Type of projecC _ New _ Addilion Remodel � Repair T I Sign Sprinkler Demolition Change of Use <br />DESCRIPTIONOFWOR�(add�onalspaceprovidedonthoback)A Hk� �`���5 �W CrC:�� S�u�Z' <br />��ki:�'�'_ (.lil�i' /� f7��:cc'. l�U�wc:t�•tLt <br />MECHANtCAL PERMIT APPLICATIQN <br />ofProjoct: _New_Addn _Altoration_Repair <br />ShowNumbcr(N/o/lixfures _ <br />A/C - air handling units <br />Other <br />PLUIVIBING PERMIT APPLICAiION <br />ofProJecL• _Nuw_ Addn ,_Mltcration_Ropa(r <br />Show Number (#) o/ /ixfures <br />Other: <br />Number of HeaJs ' <br />I PmeOy cerory �tial I ha+e �ead antl eaominetl Ihis apPliwlion antl kno�v i�e same lo ba imo antl rorred. All pmvisions ol laws and ordinances governing Ihis type ol work vn:l Ee complied <br />v:nn wnettler specifetl herein or not The g mnlin3 0l a pemiA aoes not piesume to gira authoriry lo vlolale o� cancel the provisioo 0 1 any oNer siate or lowl �arv regulating consWc6on <br />thal I am autnorized by lhe owner ol t�is pmperty to pedortn the work lor which appiication is made an01 compry wrt� the Slata Contraaors L ax 1827 RC1V aN 2962WA WAC. !� <br />% � ''� �"�C Z <br />�, �l(_, l�2��c��a�C�'l � -��3 <br />- � 1e (Ravised 62012) � <br />OwnerlAuthoAzed Agont SignaWro <br />