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a -�g-u <br />PERMIT APPLICATION <br />BUILDING/MECHANICAUPLUMBINGISIGNISPRINM;LER/DEMOLITION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 Cedar St., Everett, WA 98201 - 425-257-8870 - FAX 425-257-8857 - www.evereriwa.org <br />APPLICATIONB ARE ACCEPTED FROM 8 AM TO � PM � /( p a � O 0� <br />snnocnc• . oonocntvrexs PFNMIT• � <br />lor naw con6Vuctlon� Short <br />PERMIT APPLICATION <br />Use of Building <br />oa - d/ <br />No._ (atlech wpy ol lorq kpal de6ulptlon) <br />PRICE OF WORK <br />c)I'1•;_ -. <br />HEAT <br />Propoaed Use of Building_ � Ge�_ EkclNc Otner_ <br />8uilding lype: _ Single Femily _ Duplex _Townhouse _ Multl-Fami�y _ Commercial <br />Type ol projed: _ New _ Addition __ Remodel _ Repair _ T.I. _ Sign _Sprinkler _Demolition_Chenga of Usa <br />Deecription of Work (edCrfionel spece provlded on fhe back): n�Q�� -� ��� /.^, _� S 0 <br />� �O�_�L <br />F/ r..c .G�'� �'� `�� � - � c. SD <br />H�ve you �tarted working wlthoul a permlt9 _YES _NO <br />MECHANICAL PERMIT APPLICATION <br />of ProJaet: _New_Addn _Altantian _Repelr <br />� Other <br />SPRINKLER / SU <br />ol P�o�act: _New _Addn _Albntlon _R�p�lr <br />Show Numbar MI o/ /Ixfunr <br />Medical Ges <br />Other: <br />1 hareby cerlify Ihal I have ioed end eMamined Ihle applicallon and know Iho eama lo be Irue aM correct. AII provielona cl lm�n and oNinence� poveming <br />Ihis lypa al work will 6e complled with whelher specifed hereln or not The grenliny ol e permlt doee not presume ta pive aJlAodly lo vlole�e or cencel <br />the provislon ol eny other elale or loeal law rn�ulating conelruetlon or Ihe DeAormenee ol eonalruetlort That 1 em eutAodzad by Iha owner ol lhle prope�y <br />la ep rlorm Ihe woik lar whlch app�iaallDn Is made Bnd I comply wllh Ihe Sln�e ConVnclon Law 1827 NCW end Y98.I00 WAC <br />� �--'��: �- Z ` / �` /1 <br />ed Agonl Slgnelure Dele (Rev7sed7/�Of f) <br />