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PERMIT APPLICATION <br />BUILDING/MECHANICAL/PLUMBINGISIGNISPRINKLER/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 R AM TO 4 PM <br />SITE ADDRESS: 1-+5r IO" PROPERTY TAX# PERMIT <br />r'/�� �fe�rl)2rT ,den "Yi t <br />LEGAL for new construction, Short Plal//subdivision Lot No._ (attach copy of long legal description) <br />OWNER ^ V r- ` /� rL Phone/Email 7Z'.S32d�3 q pe <br />Address Q% ALti/. CitylState/Zip L—LefL1/ /aLQi T— <br />CONTRACTOR i/rl /"( Cl�vt� c ��1�L>fGJ�,�_� L & I Lic. # / <br />Address 2 %2�✓ —�L i� L /L/ryC, ��Jp—i"�z'^� Phone/Email <br />`'e`''�/ZS33a 2 <br />BUILDING PERMIT APPLICATION ICONTRACT PRICE OF WORK - co <br />Existing Use of Building HEAT SOURCE: <br />Proposed Use of Building /h 8�"-"/ �(/�r� Gas_ Electric_ Other <br />Building type: _ Single Family _ Duplex _Townhouse _ Multi -Family _ ommercial <br />Type of project: —New _Addition r4 Remodel _Repair _T.I. _Sign _Sprinkler _Demolition_Change of Use <br />DescJ; tion of Work fadddionaf space provided on the back):„ �<Ati5 <br />f Cr}7Mu/{i i/�F Sy•+ Pe /!%TJ� C� <br />(Have you started working without a permlt7 _YES VNO <br />MECHANICAL PERMIT APPLICATION asp 11 PLUMBING PERMIT APPLICATION <br />Ty pa of Project: _New_Addn �Alteratlon_Repair 1ItlType of Project: _New_Addn _ACaration_Repair <br />P chnw Numhor to) of fixtures <br />SUPPRESS <br />Number of <br />Medical Gas <br />Other: <br />Other: <br />I hereby certify that I have read and examined this application and know the same to be true and correct. All provisions of laws and ordinances governing <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 or cancel <br />the provision of any olh I law regulating construction or the performance of construction. That I am authorized by the owner of this property <br />to perform I r for which ap ' lion is made and I comply with the Slate Contractors Law 16.27 RCW and 296.200 WAC <br />//// /2dil <br />OWnerlAatll' ad Agent Signature {{{ Date rRevised ;RO11) �� <br />