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PERMIT APPLICATION <br />BUILDING/MECHANICAL/PLUMBING/SIGNISPRINKLER/DEMOLITION <br />CITY Of EVERETT PERMIT SERVICES <br />320D Cedar St, Everett, WA 98201 - 425-257-6810 — FAX 425-257-8857 — wwav.evereriwal.o/,�g <br />APPLICATIONS ARE ACCEPTED FROM 6 AM TO ! PM / — <br />ADDRESS: PROPERN TAI( • PERM�R i <br />702! i.�or im� /� a0 -�o b dv� <br />L lor new corsstruction: Short PWUsuDdivision La No._ (ettach copy ollorq Iepai dasuiption) <br />fNL <br />BUILDING PERMIT APPLICATION <br />Use of <br />ut! G•�tst�5e� <br />PRICE OF WORK <br />HEAT <br />�sed Use of Building — ' ' — "" .-- <br />�g type; �gle Family _, Duplez _Townhouse Multi•Family _ Commerdal ' <br />o(projeG: _New _Additlon _Remodel _ epair_T.I._Sign_Sprinkler_Demolition_Change ofUse <br />iption of Work (adddional space pmviGed on fhe bac1�: <br />Have you started working without a permit? _YES _NO <br />neECNeNICAL PERMIT APPLICATION <br />of Project• _New_,Addn _Alleretlon _Repair <br />PLUMBING <br />of ProJecC _New_Addn _Alterotlon elr <br />Medical Gas <br />Other. <br />� hereby certily that I have read and ezamined Mis appliwtion and know Ihe rame to be tnie and wnecl. FJI provisions d laws and ad'manas pwamtrq <br />this type ot work will be complied vAth whether spedfied herein w not The Brantlnp of a partnN dces rwl presume M qive eutl�wtry to violete or cancd <br />the provision of any oVrer sqte or local Ww regulatinp constrWion or Me paAamance of mnstruUion. That I am au[hor'vtC Dy Me awrxr of ihis p�vperty <br />to �erlortn Me v.ark 1or which application is made and I wmpty wiN the S ah Contrdctors Law 18.27 RCW and 296.200 WAC <br />� �^ �/�,/�� <br />OwnerlAutho Bent5lgneture � �Date (Revrsed7/2D17) <br />