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J AN-21-2011 "I :.'1 I'll •..I 1i'rHf'IM I nH. F_ I IEPrY 360 563 9131 P.n1 <br />PERMIT APPLICATION <br />BUILDING/MECHANICAL/PLUMBING/SIGN/SPRINKLER/DEMOLITION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 Cedar St. Fvl WA 98201 •425.257.8810 — FAX 425-257-8857 — www.everettwa.Grg <br />, , APPLICATIONS ARE ACCEPTED FROM s AM TO 4 PM <br />LEGAL to, row wr•ebucllun shod PIeU/uOdlvillon____ _ ______ _ Lot No._ (attach copy of long legal do9cipllon) <br />OWNER <br />PnoneB.me9 <br />Manse <br />Crylstsle/Zlp <br />CONTRACTOR <br />Ldl Lce <br />Add'uae D <br />ph <br />TENANT BUSINESSPERMIT <br />— <br />I% <br />Plh.re/C•me1 <br />BUILDING PERMIT APPLICATION <br />JCONIRACT PRICE OP WORK <br />Exleling Use of Building HEAT OURCF <br />propose' Use of fyrllding Ou Earnm elms <br />Gulid�ng lyps _ 3'ngls I"amity - Duplex _Tcwnhouas _ Muhl -Family _ Commero al <br />Typo of project: _ New _ Addition _ Remodel _ Repair _ T.I. -_ sign,_•-sprinklor _Demolillon_Change of Use <br />L)ov mipt.un of Work oelopu nit apana modad on the back). <br />Have you started working without a permit? _YLS ND <br />MECHANICAL PERMIT APPLICATION <br />PLUMBING PERMIT APPLICATION <br />Typo o(project: _Now—JLddn Alterstfon_Rapalf <br />Show Number of lhfures <br />Type of Pro)"C _New __,Addn --Attention _Repair <br />Shaw Nwnhor LIU of frxfunee <br />A/C — sir hendl,rd units <br />T01141 <br />Fo,r de.rsystems <br />thtub <br />Gas In <br />Lwslo wean begin <br />— <br />Water heater <br />Shower <br />�- <br />ee ve Inca <br />KlkAen eink 8 disposal <br />_ <br />ea nn s <br />Olshwasher <br />Clothes_�O"rr <br />Clothes washer <br />Rena oo <br />Water hooter <br />Exhaust Ion <br />6ink osrvlce��gr/mu Bic <br />Meet um <br />DodMlow rovonler <br />Unit hooter <br />U1110 <br />BCller <br />br nkin Ounts n <br />Refrl erel'on <br />Floor do n <br />Woodeave <br />I (Iasi sae ire <br />nucnrg <br />I Rent Onaing <br />Omer <br />MetllesI ge <br />SPRINK P RE88 ON 8Y TEM <br />Other <br />Number of 14e0CM <br />I "noDy certify thlt I haw nod and elamiM1 Ihle ■pp'xahen and Know the same to to I Jo and corned At pmvlolons of Iowa Ind ordinances goVDm'ng <br />tNe type of work will be COMP ad win whOlref IP0014d herewt or nol. The gnniing of a perrng dose not pril to give authenty to NOlels Or canal <br />the provision of any other $late ot local low ngulatep ODne Ouctlon m the paltononce Of construction t hot I em su thOdrsd by ITN caner Of Into PRIPeny <br />to perform I'm wurK for whiur appllcat'on Is mode and I comply with the stab Contncloo Lew 1027 RCW and 29e 200 WAC <br />_-2� 'e yam, I l <br />OwneNAuthOrbed Agent elgnoturto =Jots (NW"df2ROrn) <br />