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PERMIT APPLICaTiON <br />BUILDlNG/MECHANICALIPLUMBING/SIGN/SPRINKLER/DF_MOLITION <br />CITY OF EVERETT PERfJIIT SERVICES <br />3200 Cedar Sf., Fverett, WA 98201 - 425-257-8810 - FAX 425-257-8057 - www.everetiwa org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM )"/ G` I <br />ADDRESS: � I I_ gC V� I �I I�� 1L PROPERTY TAX N PERMIT p1 � O I– O� <br />1� N <br />lor new conslruclion: S�ort PlaUsuDd <br />BUILDING PERMIT APPtICAT10N <br />Use of Building <br />�ased Usc of Ouilding <br />No.__ (aUach copy of long legal dr.scrptian) <br />CilylStale2ip <br />L&ILicN <br />PERMIT ��, Z�j . I� ^ <br />A2LI;r0�Jl- � c `v-r <br />PRICE OF WORK <br />C �s <br />fing type: � Single Family _ Duplex _Townhousc _ Multi-family _ Commercial <br />� of projed: ,_ New _ Addilion _ Remodel _ Repair _ T.L _ Siyn _Spnnkler �Ur.moliGon_Changc of Use <br />.rip;ion of Work (addrlional space pmvided on Ihe backJ : <br />��5�'l,�v�'�1' ��-�,w��.� �kt �vG�lCl.. <br />e you slaRed working wdhout a pertnil? _YES�_NO � <br />MECHANICl1L PERMIT APPLICATIUN r <br />afPro�ecl: _New__Addn _Altoration_Repair <br />Show Num6cr (p) o! liitures <br />�NC — alr handhng units <br />Forced air systems <br />Gas piping <br />SPRINKLERISU <br />Number ol Hcads <br />SYSTEM- _ <br />PLUMBING FERMlY APPLICATION <br />of ProjecC _Naw __Addn _Alloralion _Ropalr <br />Show Num6er (M) ol (xfures <br />Kitchen sink R c <br />Di;hwashcr <br />Clothes w�sher <br />Wa�er heealr. i <br />Smk (servic;r./b,�. <br />Ilackllow prevci <br />Unnal <br />Dnnkinq Founla <br />Floor dram <br />Grcasc trap <br />Ronl Arains <br />MEdi�al Gas <br />Other <br />I herr,hy ceildy Ihat I have n!atl anJ examined U�i: applictlinn and know IIiN same iu be true anA r.�rrecL nll prnvisinns oi law: anA mAmanurs gnvemmy <br />Ihls lypo ol wnik will he cmn�ilir.A wilh wlirll�er specdied herein or nol Ihe yranling ul a pnrmil Aues nol piesuine lu grvr. auUmiily In violale or u�ncel <br />Ihe provi,i i ol any ulh^_i siale ar load law iequl.i6n�r con;IruUinn nr Oie pedwmanrn ul conslruction Ihal I am aulhoiired hy Ihr, ovn¢r ol Iliis propei�y <br />to pn �m Ih wnrk lar which apP6wiion i^ �aJe nl I com ly wilh Ihe Slalr. Contiar,tnrs I aw 19 27 RCW anJ 19ti PUO NlAC <br />:�..� ..e... .. �..,w n.. ..� u,. . ..� — � 1� I f ale (Revised7/101 U <br />