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PERMIT APPLICATION <br />BUILDING/MECHANICAL/PLUMBIN�ISIGNfSPRINKLER/DEMOLITION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 Cedar St., Everett, WA 98201 - 425-257-6810 — FAX 425-257-8857 — wsnv.everettwa.org <br />APPLICATIONS ARE ACCEPTE� FROM 8 AM TO 4 PM <br />fornewconstruction: Short <br />BUILDING PERMIT APPLICATION <br />Use of Building /-/om� <br />fY TAX N PERMIT p <br />s � �� �v�,�>��o �in7 =�� <br />No._ (aY,ach rapy of long Icgal tlescnption) <br />L 1S G+'�C��2jy+� <br />PRICE OF WORK <br />SOURCE: <br />�sed Use of�Bu/ildi9�g � 1 Vtl'— — — <br />cg type: �singie Family _ Duplex_To�mhouse _ Multi-Famiry _ Commercial <br />of project: _ New _Addition _ Remode! _ Repav _ T.I. _ Sign _Spnnkler _Demolition_Change of Use <br />of Work (additior,al space piovidetl on the back�: <br />� you sWrted workin9 without a ocrmit7 _YES (ifQO <br />MECHANICAL PERM17' APPLICATION <br />ofProject: _New_Addn _Alteration_Repair � <br />Show Number (.") ol firi� res <br />a�f <br />� r�-�toumo <br />� Unit neater <br />� Boiler <br />� Refrioeration <br />1N000stove <br />Duc;ing <br />� Other <br />SPFtINKLER I SUPPRESSION <br />PLUMBING PERMIT APPLICATION <br />otProject _New_Atldn <br />Show Numbcr !#) <br />sink <br />trao <br />Medical Gas <br />Other. <br />Other: <br />I hereby certiY� tha; I �ave read anC examined Ihis aOP�ication and know the same lo be true and c^rtecL AI� pmrisions of laxs antl orCinances govemino <br />this ryoe of work will be complied with wnether specified herein or not. The 5�nting o! a pertnit dces not presume to g��e auNonry to violate or cancet <br />Ihe provivon of any o;her state or local law regulaling constrvCion or Ne perfortrance of conshuC,ion, That I am authonzeC by the amer ot tnis pmpeny <br />tc p�rtortn the wflrk for which application is made an01 compty with Ne State Cont2C.ors Law iB.2T RCW anc'.95.200 WAC <br />_E �^ , �f�J v�/l <br />OwnerlAu hoiizc genl5ignaWre � Date (RevrsetlY2071) <br />