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PERMIT APPLICATION <br />BUILDING/MECHANICALIPLUMBING/SIGN/SPRINKLER/DEMOLITION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 Cedar St., Everell, WA 9B20'I 425-257-8810 FAX 425-257-8857 www.everettwa.org <br />nPPLICATIONS ARE ACCEPTED FROM B AM TO 4 PM �— �� —� Z <br />ADDRESS: , ! PROPERNTA%p P RMlTM ` <br />� <br />' l � <br />'I �.�� ?�._�..'.�.;.•,•.. ', /�'�J�„vC J�7'i ,.'I l]y ':O I '� � � <br />for new construction: Shorf PlaVsubdivision Lot No._ (attach copy of long legal description) <br />�� � � �- , ., .., . , . _z �Phone;E-mail <br />�., .. ..-. .. . <br />, � �A.U��'.. l� r. . " <br />� ( <br />L' <br />1-1,�:_i:' '.,ii'� �}�.. <br />Owner OvmelsAgent _CoNractor CoMractotsAgeN 7enantim�:�oro�b«�i»n^�oiw^+�mi'°m�^°°""�"o°°"°n^'^°:or�i <br />�R �'_ . ,-r:., ��:�,�r �.:r:.�l�:-_� L&ILic.# :,`J��-��(-.�L`1���1,== COEBus.Lic.#�,�-I'I?�U <br />�; .�y�., ��,i.�� r .� , <br />�� �� :i. , I . � � <br />BUILDING PERMIT APPLICATION <br />„.11�. � � <br />. � i PhonelEmail : JC � !�+7 �- � I `� ' <br />CONTACTFORPERMIT.,(i��_�,,•�;;�,�,, c <br />� .. . - I ( I" : . i . � I i � :rt r' . ( ,,..: l <br />Phone�E-mail �` <br />CONTRACT PRICE OF WORK �� �'-' ' � � ' ��'� <br />Existing Use of Building � <br />Proposed Use ol Building <br />Building type: Single Family _ Duplex _Townhouse _ Multi-Family ✓ Commercial <br />Type of project New Addition Remodel Repair ''�T.I. Sign _Sprinklei <br />DESCRIPTIONOFWORK(addrtionaispacepmv���donrhoback): i <br />.,,< <. <br />. . �� '. , . , � � ,.. .,� _� , . <br />MECHANICAL PERMIT APPLICATION <br />01 Pro�ect: _New _Addn �Alteratlon _Repalr <br />Show Number (p) o/ /lxtures <br />AIC — air handlino uniis <br />Number of <br />o( Use <br />� i � . _ <br />, ��;.--. <br />PLUMBING PERMIT APPLICATION <br />ol ProJect: _New _Addn _Alteratlon _Repalr <br />Othec <br />Gas <br />I hereby cerlM ���� � hace road and exammed t�ls appl¢alan and know Ihe same to be Vue and mrtect. AII provisons ol laws and orJinances goveming tMs lype ol work will 6e compl�etl <br />�.vnh whelhar sDocAreO hereln or not. lhe granting ot a peimil does nol Dresuma to gNa authonry to vrolale or wncei ine pmvisron ol any other stata or bcal law regulTting conslrutlion <br />inat I am aulhoi¢etl by Iho o��ner ol lhis proDeRy to pedorm IDe wvrk lor whkh aD7lralbn is matle an� I comply Hdh Ine Slate Conlrac�ors Ww 1027 RCW and 296.700A WAC. <br />' ' i i �� ' I .� <br />I . ; . ....... ; ' . � .. <br />OwnerlAuthorized Agent Signaturn <br />Date (Revised 62012) <br />