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iU e w <br />PERMIT APRLIC.ATIPJN p �u,n �e i <br />BUILDING/MECHANICAUPLUMBINGlSIGN/SPRINKLE M� OL�T�ON <br />�-- <br />CITY OF I:VERETT P�RMIT SERVICES � <br />3200 C edar St., Everett, WA 98201 -•125-257-8010 - FAX 425-257-8857 - www.evereriwa.org ,,: ���� -/�¢ <br />APPLICATIONS ARL� ACCEP7 �C FROM tl AM TO i PM •' �� <br />� <br />iW �eatonsliuciwn $hort <br />BELMONTE <br />CLLil.7 <br />SE LAKE <br />PERMIT APPLICATION <br />Use of Building <br />LHtU LotNc <br />VMm/E �mail <br />Ciry/Slate2ip <br />L 8 I Lic p <br />WA 98258 <br />�attacr�� cWv o� b^9 iegai <br />PRICE OF WORK <br />HEAT <br />K^.d Use of Buildmg CA�_ I �as— t����c_ ����r� <br />ng ry�pe __ Smgle Famity _ D�ptez _Townhouse _ Multi�Family _ Commercial <br />ol pm�ect. _ New _ Addition _ Femodel _ Repair _ TJ _ Sign _Spnnkler _Demoh!ion_Change of Use <br />DesCnption of Work faAnrtronal space pmvr0ed on !he bacA) <br />SAME <br />Havi you staRed working wilhout a permit? _YES __NO <br />MECHANICAL PERMIT APPLICATION <br />ql Pro�ect: _New _Addn _Alterellon _Repelr <br />Show NumOer (a10l /l+fares <br />A/C – av handhnq umts <br />Heal pump <br />Umt heater <br />fioJer <br />Refnqeration <br />Wuudstove <br />Ducting <br />Olher <br />NKLERISUPPRESS <br />Numher of Heads <br />PERMIlr <br />ol ProJxt: _New _AdAn _Altentlon _Repalr <br />�nnki� PouMain <br />Floor drein <br />Grease trap <br />Roof dreins <br />Medical Gas <br />Other <br />Other <br />i hereny cen�fy Ihat I have read and e.amrt�f Ihis aDD��cation and know Ihe eame to be true anA conect All pmvisions o� laws ana oMinances govem�ng <br />�nis lype o� v.od wtll he CAmpbeU vnih whether SpeuM1etl M1Crem or noi l�e p2n�uq ol a pertni� Aoes n0i pesUme lo grvC au�honty lo vroldie o! ter Cfl <br />ine v����s�on o� any olher state o� locai law regulatinq wnstmd�on or Ihe pedortnance of conatmctwn Tnal I am authonzeA Dy t�e on+mr of t�is pn�perty <br />io pedn�m Ine Mork lor wh¢h appl�catron is maefe and I comCly wt� Ihe State Conlractas law 18 77 RCW anU 299 200 WAC <br />��.�-� -- r-� ��'/ 3 / i r <br />bwner/11Whotlretl Agent Slgne ure T- Dale 1Revisei 7�lOi11 <br />