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From: 0917"'2012 07:50 r358 P.002/003 <br />PERMIT APPLICATION �v��� <br />BUILDINGIMECHANICALIPLUMBING/SlGN/SPRINKLER/DEMOLITION <br />CITY OF EVERETT PERMIT SERVICES <br />32D0 Cedar SL, L-veretl, W� 98201 425�7.57-8810 FAX 425-257-8857 vnv�v.everettwa org <br />APPLICATIONS ARE ACC[PTED FROM 8 AM TO a PM <br />enORFSR� _ . .� VftOPLRTYTA%q PF(�'IT� _i-. .:Y <br />�ornCwconSVUU�un. Shoii <br />PLICANT: _ Onner _ Owie� s A3ent <br />1'L�col l:�z ��e_ <br />No __, (atlar� copY o� ioig lepal tlesv�p�ion� <br />ICitY�StaNJZiP � UQ�e.'I"�F, W pt �5�� <br />Contnctor __Conuactof6Agent __tenant�m:ut���•��^^�^��'�n•n��emo-.�..�vav<.o���n�..o.�<.i <br />BUILDlNG PERMIT APPLICATION <br />�I.SILic.N <br />�.lA `�Y,03�I- <br />�L <br />_}�'�i\ iY). <br />RACT PRIC[ OF WORK <br />0 <br />CziS�i��y Use ol 6wlding nv� i a�un�.c. <br />Pru0ose4 Use ol Owltling Gat� [icctric Otner.___ _ <br />[3uiltling type: _ Single Family _ DUFIe� _l c.wnhouse _ A7ufli�FemJy _ Commercial <br />Type ol proiecP New Adtlilion Remotlel Nepair TJ Siqn Sp�mkler __I7emohlion_Change ol Use <br />UESCRIPTION OF WORK �adtlitronal space pioviJCC on �he back). <br />I�PJ'"`a�e a- rf,plac� G�aS t.�'�a.+�� �aa-I�ec- wi�l-� -��IeSS uni-1- <br />PERMIT <br />PmJecf _New _Atldn <br />Shuw NumLur !Ml <br />au <br />KLER/SUPPRESS <br />N�mber Of Heatls <br />�LICATION PLU11'IBING PERMIT APPLICATION <br />_Repalr lypcofProjc<l: _ NCw Atltln Alterallon_Hepalr <br />Snow NurnDer (a) ol lirmms <br />dia <br />f2uol tlrans <br />Idetl¢al Gas <br />V1 <br />i ncreLy cnril� iCel l^.m e rexif x�n: eumineU 11'�u epr�=aLun x��� ��cw 11+u tema l0 4o Vnn en� correcf NI o�uni.ore o! laws ena o�en�n[e� povermnp iNs ryre c1 wm� w10v :: eG rJ <br />wl!� w9ell�c� sprtrRco f�etm� o npl 1�0 p•anhn0 cl a pefmil Qoes ncl C�e�ume lo � vc aulptlXY �� Nolele cr CCn[cl ln! p�ovnM ol �ny pOer ����,y u� Ucll liw rvpe:nLnp lcnsl��„r.4nn <br />1hu; l an e�l!mn:mf f y il'c pnrsr nl t� F pmpanY �� Ui�inmi I�n wa'� lur whe� epC����rn n meCe orOl mmp1� w141oe Slale CCNrRtor� l�n 10 ]i �2CW m�0 2P61CO� WFC <br />/ 11� � 1/i ���I /I'� <br />� \ ✓v <br />Qv�J� . IAutt�onletl Agent Signature I::,;e (Rev,sej 6�'.'0�%1 <br />�/ <br />