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PERMIT APPLICATION <br />BUILDIfVG/MECHANICALIPLUMBINGISIGNISPRINKLERIDEMOLITI6N <br />CITY OF EVERETT PERMIT SERV!CES <br />3200 Cedar St , Everett, WA 98201 425-257-8810 FAX 425-257-8857 www.everettwa.org <br />APPLICATIONS ARE ACCEPTED FRUM 8 AM TO 4 PM �.--aS'--I <br />ADDRESS: _ � _ _ '. . . _ PROPERiYTAX� ^ ^r. 11 lr�� I P��Ii�I ( �7/: %' I,� <br />fornewconsirucuon: Short <br />Phone/E-rnail <br />(attach coOY oi long legal descripbon) <br />Q�mer Owner'sFgent �Contrac:or _Contractor'sAgent Tenant�m��sio�o.acaie^e�aco�semuommem.�e<<oa.�»o�����esca:��� <br />81Lic.N ��iP�Q\h�cL� COEBus. <br />Fnone�Email I r _ _ �" ' 7 <br />ONTA T FOR PERMIT���G^\��\ <br />i�� <br />BUILDING PERMIT APPLICATIdN CONTRACT PRICE OF WORK <br />Exisling Use of Buildiny _ _— — <br />Proposed Use of B/uilding__ _ �' <br />Building rype: y Single Family _ Duplex _Townhouse _ Multi-Family __ Commercial <br />Tvoe of oroiec�: New __ Addition �. Remodel __ _ Repair __ T.I. ___ Sign __Sprinkler __I <br />ESCRIPTION OF WORK (addilional sprce A�ovided on fhe back) : <br />��`."� 1��� ���\\'��.�.�. j �,.��1.,� ��.\��� <br />MECHANICAL P[RMIT APPLICATION <br />of ProjecC _New,_Addn LAl�eratlon _Repair <br />Number of <br />af Use <br />PLUMBING PERMIT APPLICATION <br />of PrqecC _New _Atldn _Al�oraHon _Repair <br />Show Numbcr /pl o/ Rxtures <br />Medical <br />Othec <br />I nrreey uaU�. R�tV I nmu rentl �ntl exaimne<f �n�s nGl�lrnton ano know Ihe snme m �o vue antl cortec� All Drov5bn5 0� �aws and or]mances govemmg ihis type cf work.r�ll be completl <br />v.Ah whellxr SpucA�ed I�emm a� iot lhe g�a.�im9 0l ri prnn,l cloes nol piesume lo 9rvu ai4fior4y lo voldt¢ 0� ean[al (he pmv�sion ol any ol�er sidte 0� bcal Ww reguLil�ng conSVuc�ron <br />1 h:A 1 nm aulhoiaeA by ihe mvner al In5 properry �o pedom�. tnu �wrl.lu� n�u<n appLCMnn rs matle anE I comOty vnlh Ihe S�a�e Conlmctors Law 1B 27 RCW anE Y9G 200A WAG <br />� �G���Z�� �G 7��� <br />� � <br />OwnedAuthorized Agent Signature Dale jRevised 6/201'l) <br />