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PERMIT APPLICATION <br />BUILDINGIMECHANICALIPLJMBINGISIGNISPRINKLERIDEMOLITION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 Cedar Sl., Everett, WA 98201 425-257-8810 FAX 425-257-8857 www.everettwa.org �, <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM T� <br />� <br />newconsiruction: ShohPlaUsubdivision <br />HTV TAX N � <br />k3`il-N77-D3v-v� '. ' <br />Lol No._ (allacii wpy ot long legal descnpiion) <br />' _.. !i � `� i i �/ � — /) Li �%� <br />Owner _OwnMsAgent _Coniractor ,_Conlracb�'sA9eN _iCwnt(�,miv�o•ti���T1p1ontCi1h0mmao..nn'oaownnne�p+w) <br />G <br /># <br />BllILDING Pf:RMiT APPLICATION CONTRACT PRICE OF WORK <br />Exisling Use of Bui!tling .7 F�+ <br />G� <br />Proposed Use ot,B/uiltling <br />Ouilding type: v Single Family _ Duplex Townhouse _Mulli-Famiry _ Commercial <br />Type of �rojPct New Addition _ Remodel _ Repair __ T.I. _ Sign Sprinkler _I <br />nESCRIPTION OF W,ORK jada�ionai spa/ A,,e^ rov��d� c bacti) � <br />��L.�.C�' � •���L�t.�� <br />.n.�i� i; r�'!!!%.r , t�!'�i` <br />MECHANICAL PE <br />iype of Pro�ect: _New OVAi <br />.show Number <br />APPLICATION <br />Alteration _Repair <br />units <br />Bus. Lic # <br />T SOURCE: <br />:leclnq__, Ot�er <br />�o Chanae oll <br />/�LwT// G%(.�•O �ICG�IC�i.I�. <br />'i J <br />of ProJeet: _New <br />PERM <br />Other <br />LICATION <br />_Repalr <br />Numbcr of Hr,ads ' <br />I Oeiel�y ccibfy IIm� � have �eatl and eiummed �Ois nDDlictl:on an� Anmv Ne same lo De Irua and wrtecl. Pll pmvanm ol o�'qn�o;; ^Yaol�er sl. Ie or local hw rcpulili p o��.. N i n4ed <br />wM �Nictt�cr :peofma �em'in nr not. Tlin pr.�N�np o' a pertnil �mm �ol ptesumc lo gHc aut�omy m vioLilc o� canrcl Ne p <br />That I am out�on+cd Iry Ihe owne� ol1Ai� pmpciN In Vedonn tbe wak fo� whirl� app6caUon b ma��e and 1 mmPN �h tl�c Slale ConVadnrs l:rN iB.27 RCW ��n� 73fl 7W� WAC <br />,�/�S� • C ll��l '/ %/ �% %�!/i. �J <br />Ownor�Aulho iretl �genl519naWre ���� <br />(Revisc0 6R01?1 <br />