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PERMIT APPLICATION <br />BUILDIlVGIMECHANICALIPLUMBING/SIGNISPRINKLER/DEMOLITION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 Cedar St., Everett, WA 98201 425-257-8810 FAX 425-257-8857 www.evere��a. f�` r/ <br />9�1-. f�.� l.�l, (�J�,-C� <br />Tax a <br />for new constmclion: Short Platlsubdivision Lol Mo._ (�ttach copy of long legal description) <br />, N/J.,.//�.r,.. %rn.,�, <br />Phone/E-mail f7�4`g.J�-5�13 lN/�77�7-2�� ��' fP��S,nrr) <br />-� -/;.. <br />r��-i, '�L V4Nl�Vl (Cc�c�c<<f'�. <br />PLICANT: 'JLOwner _Owner'sAgenl _Contractor _Coniractor'sAe�ent _Tenant�m�:i�ro��aeaieucr�rcc�sson�om�hao«�=rmoo���on����mesa-.�� <br />BUILDIPIG PERMIT APPLICATIBN <br />q Clty Bus. Lic. # <br />Phone/Email <br />i FOR PERMIT <br />(�0��-�3�- 55i3 <br />��i ,����frz,.� (�`�.�pCus, r <br />CT PRICE OF WORK �/%G U <br />HEAT SOURCE: <br />Existing Use of Building / <br />Proposed Use of Building CE��`e�'�/ �« l� �'u`Q!�- <br />Building type: _ Single Family �Duplex _Townhouse _ Multi-Family _ Commercial <br />Type of projecC New _�ddi�ion _ Remodel _ Repair _ T.I. _ Sigo _Sprinkle <br />DESCRIPTION OF W ORK (additionai space provid�d on the back): <br />�i'L-''f.'�4'!'( �C',�ttit-=%\ 5��;.:Ci�tLtifL �!'/�Cl7rl <br />MECHANICAI. PERMIT APPLICAYION <br />ofProjech _New_Addn _Alteration_Repair <br />Show Number (#1 0l /ixfures <br />air <br />IJumber <br />of <br />PLllMBING PERMIT APPLICATION <br />o( ProjecC _New �Addn _AltoreUon _Ropair <br />Show Num6er (tt) o( lixfums <br />nk <br />Medical <br />Other: <br />Other: <br />I hereby cehdy thal I have read z��id exnm�ned Ihls ap,7.ca��m� ard hna:v t�e same to 6e truo and mrred. Ail provisions ol lews entl ordinances goveming �his t1Fz ol v:ork �a�Cl 6e mmp'��=tl <br />�. �.:�� :�.n_ther specilietl herein o nol. T�e �qram�ng cl a Fennn tloes not presume to give amnonty to vioiate or cancel the pwvision ol any omer stala or iacal!a�.v regvlating construction � <br />'� i.��: I arn o��honzed 6y Ihe e::ner ol Ipi pmperty lo pe�orm Ihe work lor w��ch applicalion is matle and I comply wifh the Stafe Contradoro Law 1827 RCW an7 Z°6200A VJAG �� <br />. __.. �l�F � i <br />j/- ..� � �n'�� �� ���� <br />C�� . .. -:�d':FC731 <br />OwncrlA�:a A ont ignaturo I)ato <br />