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10726 21ST PL W 2016-01-01 MF Import
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10726 21ST PL W 2016-01-01 MF Import
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Last modified
4/10/2017 9:11:44 AM
Creation date
4/2/2017 4:25:28 PM
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Address Document
Street Name
21ST PL W
Street Number
10726
Imported From Microfiche
Yes
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A,�.26. 2i�12 1D:1�AM EV,�'�'REEN STATE HEAi � AC <br />PERMIT APPLICATIOIV <br />1'o.1S2� �. <br />F3UILDING/MECHANICALIPLUMBING/SIGNISPRINKLER/DEMOLI710N <br />CITY OF EVERETT PERMIT SERVICES <br />320Q Cedar St., Evorett, WA 98201 - 425-257-8610 —�AX 425-7.57-8857 — wNw.everettwa.org <br />APPLICATIDNS ARE ACCEPTED FROM 8 AM 70 4 PM <br />ACDRESS: I �� ^ � � � P� \,�, pROPEHttTNtq PERMI7Z� _O� <br />d• `r V <br />,Llornewconalruulon: StrortPiatlsubalvlslon LotNo.__ (allachmpyeflong7egeldaecriplianj <br />� 1 � <br />81 <br />O ��L <br />PERMIT APPLICATION <br />Use of ouliding <br />PRICE <br />' y25-a <br />� <br />C.o�.r��- <br />HEA7 <br />�d Use o�ullding_�-� •�"� � Gas_ Eiecuir.� oma� <br />lype: Single Family ,_, Guplex_Townhou6e _ Mulll-Famlly _ Commerdal <br />projact: _New _Addlllon _Remodel _Repair_T.I._,Sign,_Sprinkler_Demolll(on_Change o(�Use <br />scdpllon of Work (adaVtbn�l s,�ce provNea on me 6eck): <br />�juc.-�-�'�c� �lL. `�' • <br />you slarted working wllhout a permft9 _YES � NO <br />MECHANICAL <br />of P�oJecl: _New_Addn „j[Attaratlon_Repeir <br />snu:v NumbarlMl o/ Oxfurea <br />PERMIT <br />of PtoJeet: _ N�w_Addn _Altenllon_Repelr <br />Medical Gas � <br />Olher. <br />� I NumberofHeeds II I umer. <br />I here6y cuUy that I have re�d and aYemined Ihie eppicetion and Wmw Ihe same lo be true aM correcL!JI provfsione ol krAo and ordinarkas QovemN� <br />Inis lype oivxxk w111 be complled vA�h vAieNer cnadfiad herein ornoL 7he gronting of a permll0oes nol Dresu;ne lo give euNMly ta vblale ar concel <br />me proviebn ol sny olher state or laal Ww re0ufaling conswGlon ar Ina pedormenu o( wwlruction. Thet I em euUwnzed by 1na ornarof lnis propedy <br />lo ryeAotm Ihe work t«v.hich epplicalbn ie mede and 1 comD�Y�� �� ���e Conlraaorc law 7B.2T RCW ■nd 286.2(q WAC <br />,rJe -2�-1�. <br />Ow ulhor'aedAgantSigneture Date (ReWsedY1011) <br />
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