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PERMIT APPLICATION <br />BUIL.QING/MECHANICAUPLUMBING/SIGN/SPRINKLER/DEMOLITION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 Cedar St., Everett, WA 98201 - 425-257-8610 — FAX 425-257-8857 — wwa+.everettwa.org <br />APPLIG0TI6NS ARE ACCEPTED FROM E AM TO � PM <br />� <br />� <br />fornewwr�sVuction: Short <br />lJdMSn�G "S�(LI <br />NG PERMI f APPLICATION <br />Ezisting Use ol Building t�Jo mC <br />TAX � <br />N0._ (ettatli coPY d �q �I Oe�aiP6on) <br />ut! 4ne.sUtse,� <br />PRICE OF WORK <br />Proposed Use of Building � — '" ."— - -- <br />Building type: �ingle Family _ Duplez _Townhouse _ Multi-Family _ Commercial <br />Type of projeG: _ New _ Addition _ Remodel �epair _ T.I. _ Sign _Sprinkler _DemoliN�n_Change of Use <br />Desaiption of Work (adddional spece pro✓ided on the baclq: <br />Have you shrted working without a pertnit4 _YES V NO <br />MECHANICAL <br />olProject: _New_Addn _Alleratlon_Repelr <br />Cher NumDef !/1 0/ (IATufBS <br />PERMIT <br />otProject: _Naw_Addn _Allenllon <br />Medical Gas <br />Olher. <br />� I Number of Head- I I i vmn�. __ <br />I hereby certiy that I have read anA examinetl this eppliw6on and Anow the same to be hue and cortecC Ail provisions of laws antl adinances govemirq <br />this rype ot w�rk will be complied wilh wnether spedfieC herein or not. The granling of a pertnit dces nol presume to Bive authority to vidale w ancel <br />lhe provision ot any othar sWte or local law reCulalirp construcl�on or Me performance of consWtion. That I am authorized by Me o.vnar of Mis p�opaRy <br />(_ �to {» r lhe work for which appliwtion is matle antl I complyvn/jh Ne State ConinGors Law 18.27 RCW and 296.2D� WAC <br />,,,a,y TI �1 I� (Revisetl7/2011J <br />OwnerlAuthortz AgentSigneture d <br />