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PERMIT APPLICATION <br />BUILDING/MECHANICAL/PLUMBING/SIGN/SPRINKLER/DEMOLITION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 Cedar St., Everett, WA 98201 425-257-8810 FAX 425-257-8857 www.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM q ` 4 -/ cam. <br />—1 ` /� Et, PROPERTY TAX PERMT# <br />ADDRESS: <br />t^3Z E�`aiULSC L,37- <br />for new constructionShort Plat/subdivision C'r ^' 1 %gyp"(11 q LotNo. (attach copy of long legal description) <br />fL j J-"^JPhonelE-mail L4L�- <br />Owners Agent _Contractor _Contractors Agent _Tenant (most provide a caner cfconsem from the o+ror to do work in m+space) <br />Lic. # <br />aszn <br />BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK <br />Existing Use of Building �'J - - i Ot <br />Proposed Use of Building <br />Nbhc, D; <br />Building type: ,single Family _ Duplex _Townhouse _ Multi -Family _ Commercial <br />.. oe..,,.dol Renair T.I. Sign_Sprinkler <br />DESCRIPTION OF WORK (additional space provided on the back): <br />MECHANICAL PERMIT APPLICATION <br />of Project: Now _Adds Alteration _Repair <br />NK <br />of <br />Lie. # <br />`125�3'�3-9a5's� <br />PLUMBING PERMIT APPLICATION <br />pe of Project: _Now_Addn _Alteration _Repair <br />Show Number (#) of fixtures <br />Other: <br />Other: <br />Gas <br />1 hereby caddy that I have read and examined this application and know the same to be true and = eet. AN provisions of laws and ordinances governing this type of work will be complied <br />with whether specified herein or not. The granting of a penny does not presume to give allthOrHy to violate or cancel the provision of any other state or local law regulating construction <br />That I am authorized by the oYmlrr of this property to perform the work for which application is made and I comply with the State Contractors Law 18.27 RCW and 296.200A WAC. <br />�^ Z (Revised 612012) <br />OwnerlAt t d Agent Signature Dale <br />