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PERMIT APPLICATION <br />BUILDING/MECHANIGAI_lPLUMBINGISIGN/SPRINKLER/U�MOLITION <br />CITY OF EVERETT PERMIT SERVICES <br />L . . � 2U1 - .t`-: ` 5 iv— F, . . •12`-i57-. _- �.erE+'�•.a G�g <br />l _ _�1 :r' �-��_c � � ` <br />APPI.ICAI"IONS ARE ACCEPTED FROhi 8 A�d TO 4 PM <br />SiTE ADGRE55: �� <br />? /I.� 4 . � ..c•17t•`�,fQOGJ'/CC � <br />LEGAL �cr nrr+wnslmcLnn Short °Inl�subdivision!� ���_���� �_� �"'� � Lol No. �'/ rat�ach �cpy cl i��a L•.inl descript��ri <br />OWNER �j\\k �• � 1.H ��' �.' � �-: ^hone6mail �� 7•��-514 �� ���%� <br />-- � 7 � � �� <br />� _ I f � �-� � / GltylState/Zip ��, V C K G-i �'N Ia ! 6- G s <br />r.dmess I / t�l. <br />CONTRACTOR �\ \ � f '.. 1 r� ��l'�" ' �� {" N � L : I Lr �' 1\ � � P 1 �� N % (^ ��_�' ��' <br />qdtlr�:'.s I�I �-. /'I n� f. ��'Ild, i� : llp-i �- I,1 ni H1� �f �.\'��.7 Phonc-Email � 7� 'I �o' -�.OI� <br />���...,.,...,....._.._...._._ y,,,�.,. l �; rt7,. <br />FhonNcmall �� : 'i J Ir 3l� �1 � <br />BUILDING PERMIT APPLICATION CONTRACTPRICEOF WORK ��[>O <br />HEAT SOURCE�. <br />6ish�g U5e of 13uddin9 _ ______.—.—_ -._.--- <br />Propased Use ol 6wlding Gas_ Elcr,trir._ OR�^r <br />Building type: _ Single Family _ Duplex _Townhouse _ Idulti-Family _ Commercial <br />Type of pro)ecl: _ New __ Addllion _ Remodel _ Repalr _ T.I. _ Sfgn _Sprinkler _Demolition_Chnnge ol Use <br />p^scription ol VJork �,ndJ�h:z�a�.sc�arc p•,�,dr9 on mo Dau�l. � � j'� � � �� E'� iJ,.. � <br />,-5���`. ��l.i '�1 �'I�A.'�L � � �_ l� (� (f' .1�1� � ��il'�� fl <br />T���+�I��lil �� ,r - <br />♦ / <br />�(! � � .' � `Jillc �l` 1.��.�1'��- / <br />Have you started working wittrou! a permit7 ,_YES �NO <br />MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br />Typc oi ProjrcC _Newr��ddn ,_Alleration __Repair Typo ol ProJeCV ShoweNumbrrd(XJ o/flxfum$`ion _Repel� <br />ShowNumber(p! o/O.lurrs <br />_ i h'C - air handlina unrts � i Todet <br />i For,-=d a�r svstems Ba�htub <br />lVater <br />SPRINKLER / SUPPRESSION SYSTEM I Other <br />:.�_ .i,..;,, � <br />. �;; y_en'�ty Ihul' 1'.aJe �^a9 u'�9 m.anv::�'^. i'��s apFi���bon arC Anua I��e snme Ic 6e Irue and conect. All provisions of laws entl ordinences B�'�ern''.`.. <br />���.�. t�pe o1 wort. wul be complietl wfth whelh>i specifetl herein or not. The prantlny of a De�mit does not presune to p�ve ai�thority Ie violate ur ca�cei <br />�� r��ovlsion ol any olher stnta or locel lew regulati�g consiruclion or the peAormance of construction. That i � m euthc��: u7 ,�� n= c':.'�e� o' �'�'�� 6"'�� P"�'i <br />�. raorm !�e v�rt lor w�,i'^� aop'.'catm� is mAUe nnd I comply wilh ihe SIaIe Contrecforc Lew 18: i RC4N antl 298 2�.^ `::�.�� <br />. /� - I <br />--�'-`=—:_.—�- L1.------- <br />V�mrr Authm�: i-�1 Aqent Signntuir :+'!- <br />