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PERMIT APPLICATION <br />BUILDING/MECHANICAL/PLUMBINGISIGNISPRINKLER/DEMOLITION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 Cedar St., Everetl, WA 98201 425-257-8810 FAX 425-257-8857 v,n�nv.everettvra org <br />Ior new consWclwn <br />S <br />TAl( p <br />tl <br />No._ (aUach copy ol long legal de,crphon) <br />__pwrer _O�vner'sAgenl�C`ntredcr _ConlraetofsAgenl _Tenant;-ns�,.o+�,�mrerc�m.,vr.iromvao.�,,...veo.oh,,nasra��i <br />�o(Icqc. Pla� <br />LDING PERMIT APPLICATION <br />Uc # 15f.� � -!� Crt ous <br />�i,� P��cne/Email <br />"ACT FOR PERMIT <br />C�o� •�, R��"+- p <br />,E.mai� �-?`l7-'-�Sv I <br />"RACTPRICEOFWORK �%)�7(}j}�C <br />Ezis�ing Use of Buu'ding �.•�: k'� �--cr.� <br />ProDosed Usc olOudC��ng <br />Bwlding lype: _ Smgle Famdy _ Duplex _Townhouse _ Muiti-Famdy <br />Type oi projecf New Addrtion _ Remodel Repair _ T.L _ <br />DESCRIPTION OF WORK �ada r�cnai space p�or drd on me eac <br />c:ve,���� a �,� cri.�,�cc�5< ��;t�� <br />C,�1 � t.Je�S� i.v;;�����ci'� <br />MECHANICAL PERMIT APPI.ICATION <br />o1ProJacl: _Now_Atldn _Altoration_Rapalr <br />Show NumDrr (a) ollirfwes <br />NC — �ir handhng ur.its <br />I Forced a��r sVstems <br />SPR <br />Gas <br />Ex <br />NumberolHeads <br />ION SYS <br />SOURC[ <br />_Commernal <br />gn _Spnnklcr _Demolltion Change of Use <br />���,�— �`5�,� i���,�o�`��.r K <br />PLUfN81NG PERMIT APPLICATION <br />of Pro�ed: _Now _Addn _Altoralion _Ropalr <br />Show Numbrr (M) ol lixfums <br />Medical Gas <br />Other <br />I �ereCY �eMy IAaI I �avo mad anO c�ammM Ihu aGC�'��on �n� Anow I�a samo to �o tNc anC Cortett All pmv6iJn5 of ldw� arG a'C�nances gJremin9 ��u tyDe o� work w:l Le comp;ed <br />w�� wTe�ner specf,MG heRin or not. The g�anlingDf a DertnB 0Ms not prcsumo 10 5Yc av:nerly to violdte or Untt111c piovision c! any c'^.^i s:dle or lo[-�I �aw regdaL�3 ��s'r.•.7�a� <br />Thai I am autnorssM OY ��e vwner ol In�e pmpe ' o do;m f0e wmA ICr vAicll GDD��w�b� �5 maOc On01 fpmply xtl� I�B $IaIC CorhaCprs Law 1B :7 RCVJ a�d ;?G:J.4 \\'A�� <br />1 <br />_L1. J% / � <br />— ,l/ � %✓l� �-�' l 1 <br />OwnodAul ddzedAgantSlgnaturo Date (Fe���:eeL.'Jt3) <br />