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PERMIT APPLICATION <br />BUILDING/MECHANICAUPLUMBINGISIGN/SPRINKLERIDEMOLITION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 Cedar St., Everett, WA 98201 - 425-257-8810 — FAX 425-257-8857 — www.everettwa.or /O // <br />APPLICATIONS ARE ACCEPTED FROM B AM TO 4 PM � / <br />ADDRESS: 7ROFERTYTA%p P�RM�F ' OD� <br />'J/�2 � i�:.�; 1.. `iE �� <br />lor new consiruclion� Short <br />(� <br />81 <br />BUILDING PERMIT Af�PLICATION <br />_Lol No._ (etlach copy ol lonp lepal deacription) <br />PRICE OF WORK <br />Ezisting Use ol8wlding _5� '� _ HEAT SOURCE: <br />Proposed Use of Building S� �c�c F��li � Gas Electric� Other_ <br />Building �ype: � Single Family _ Duplex _Townhouse _ Mulli�Family _ Cammercial <br />Type ol projecL _ New _ Addition � Remodel _ Repeir _ T.I. _ Sign _Sprinkler _Demolition_Change of Use <br />Descrolion of WOrk (eddrtiona(l space provided on fhe back): (1 /y� I� 1( <br />�(;�l.l. Wltlhi�W`) ���1� C/t,l�ll'� t10.MVi� � l.r�i�c:1A� lA1SV'IC�1C11 ���IµP�- (X�1A� <br />J <br />Have you staAed working without a permil7 _YES _NO <br />MECHANICAL PERMIT APPLICATION <br />ol ProJecC _New_Addn _Altontlon _Ropelr <br />Show Number(k) ol /lrfuree <br />A/C _ air handlina unds <br />Other <br />I SUPPRESSION <br />PLUMBING PERMIT <br />o1ProJoet: _New_Addn _A1leniton_Rapair <br />Medical Gas <br />Other: <br />I hereby certlty I�el I have read and ezamined this appiicatlon and know Ihe seme to he trua antl coved. All provislons ol laws end oNinancee poveming <br />Ihis type ol work will Ue cemplied with whether speclfeA nerein or noL 7he pranling ol e permit does not preeume lo pive authotlty lo vlolate or cancel <br />ihe provision ol eny ot�er state or local law regulaling conslrucllon cr Ihe paAormance ol conslruction That I am authodzed by the avmer ol lhia property <br />�o peAorm Ihe work fo� wnich applicallon ie mede antl I comply vnlh Ihe Stele Conlraclors Law 18.27 RCW end 298.200 WAC <br />�7 / <br />��n,,� ,Y �. _ � L� I L� t� ID-II <br />OwnerlAulhorized'Agent Sipn�lurq Oate (�V1°Bd ��� �� <br />,�i�tna�kv�� `.�_�w��- <br />