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PERMIT APPLICATION <br />BUILDINGil HANICAL/PLUMBING/SIGN/SPRIN KLER/DEMOLITION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 Cedar St., E r lt, WA 98201 - 425-297-8810 - FAX 425-257-8857 - www.everettwa org <br />�� APPLICATIONS ARE ACCEPTED FROM a AM TO 4 PM <br />PROP[RTY TAxh PER T <br />ADDRESS: I //D�-41� <br />r1-ir&,refrl <br />t,v <br />3AL for new construction. Short Playsubdrvision _ _Lot No _ (attach copy of long legal description) <br />PhonetE•mail YZS 5B S ro oSep I <br />MER 1 cL p% <br />ryt f✓'j <br />ress l c: I Z 1 3 rxf ?L r" L Ciylslalelzip <br />NTRACTOR <br />C s ew+5 Lsluea C,I?SySs*uoo�S <br />17S l Ke-1-1 ,r-f CJq qb u z X Phone/Email <br />RPhone/Email'id 3" ` 4� Z _ U s 9 S Si <br />tress 25 <br />wt <br />ueuT ISWFSS NAME CONTACT FOR PE✓[n �y�6b <br />�a <br />1 r! L TPhone C k o c bS -- vat. 0� <br />BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK h(-( c-c- <br />(r M ,rc , ' HEAT SOURCE: <br />:xisting Use of Building <br />Imposed Use of Building SC. t Gas Electric other_ _ <br />3ullding type: _ Single Family _ Duplex _Townhouse _ Multi -Family Commercial <br />type of project: _ New _Addition _ Remodel _ Repairer( T.I. _ Sign _Spdnkler_Demolition_Change of Use <br />]escriction of Work (additional space provided on the back): <br />Have you started working wiRtout a permit? _YES _i_-_NO <br />MECHANICAL PERMIT APPLICATION <br />Typo of Project: Now _Addn _Alteration _Repair <br />Show Number (a) of fixtures <br />Air _ air handling units <br />Other <br />/SU <br />PLUMBING PERMIT APPLICATION <br />Typo of Project _Now _Addn _Alteration _Repair <br />chew Number tat of fixtures <br />Medical Gas <br />Other, <br />1 Number of Ileads I I II hereby — <br />nd know the some to <br />e two and correct <br />l provisions of <br />am and ordinances <br />this type ofnworkhwilllbe complied withx <br />xwhether specified herein or not The granting ola permit does not presume to give atgoverning <br />have read and eamined this applicationauthority to violate or cancel <br />the provision of any other stale or local low regulating <br />lIAwmntclion or the wilh Slate ors Lowconstruction. of B7 RCW and 299.200 WACy the owner of this property <br />the Con <br />topeerlAu a work for which a P 7 <br />..n (Revised 212011) <br />o xod Agan Igneture Date <br />