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PERMIT APPLICATION <br />BUILDING/MECHANICAL/PLUMBINGISIGN/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 S AM TO 4 PM pERMfo a— a % — I/ <br />;ITEADDRESS: Ai ,Q ND P.L 5t 005-17g00000300 Ii <br />Lot No. _ (attach upy of long legal desniptior) <br />-EGAL for new construction Shod Platisubd,visloll ____ ___--- 9O Sf— 3 Y 6a• <br />� � PhonalE me y2S �S ��L� <br />OWNER Gre .1 Do/n c <br />lddress I O 7.�7 pl P/ SL ClfylState/Zip E r W <br />L 6 I Lic. N <br />CONTRACTOR O %t!%� yzy 35i -J8(oL �P �r_'F3 y <br />/n^nh� P/. 5� PnonelEmell <br />4ddress e7ec CONTACT FOR PERMIT <br />TENANT BUSINESS NAME <br />PhonolE ina,l <br />BUILDING PERMIT APPLICATION <br />CONTRACT PRICE OF WORK <br />HEAT SOURCE: <br />Existing Use of Building <br />Ei,,.r,l„ Other <br />Proposed Use of Building <br />Building type: ,_ Single Family _ Duplex _Townhouse _ Multi -Family — Commercial <br />Type of pmjed: _, New _ Addition _- Remodel _ Repair _ T.I. _, Sign _Sprinkler —Demolition—Change of Use <br />Description of Work (additional space provided on the Dock): <br />D4n-r4 <br />Have you started working without a permit? ___YES -X—NO RMIT ntoaLICATIO <br />MECHANICAL PERMIT APPLICATION <br />of Project: Now _Addn _,Alteration _Repair <br />PLUMBING PE <br />Typo of Project: _New_Addn _Alteration_Repair <br />Medical Gas <br />Other: <br />Number of Heads <br />ct. All provisions of laws end ordinances governing <br />1 hereby certify that I have read and examined this application and know the same to be true and corre <br />this type of work will be complied with whether specified herein or not. The granting of a permit does not presume to give authority to violate this <br />cancel <br />the provision of any other slate or local law regulating construction or the performance of construction. That I am oulhurized by the owner of Ihia properly <br />AownsrlAut <br />he work for which application is made and I comply with the Slate Contractors Law 16 27 RCW end 298.200 WAC <br />st „2 l "Z1 "// (Revised 212011) <br />ho ad Agent Slgn ura <br />Date <br />