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f <br />PERMIT APPLICATlON <br />BUILDINGIMECH�+NICALIPLUMBINGISIGNISPRINKLERIDEMOLITION <br />CITY OF EVERETT PERMIr SERVICES <br />3200 Cedar St., Everelt, WA 98201 - 425-257-8810 — FAX 425-257-8857 — www.everettwa.org <br />APPLICATIONSAREACCEPTEDFROMBAMT04PM c03g541S100 b�i <br />PROPERTYTARk �i'��17D02DIODr'j P RMITp <br />ADDRESS: n — UI <br />��.. ._.... .I,..e„ i�, rov.o ifi �1I %�' 9Yl �A I 29GS1 iCD20�5DO 7A0517l02O!(i60 � <br />lornewwnstrucbon: Short <br />ILDING PERMIT APPLICATION <br />Usc ol Building <br />No. lattach wpy of long <br />iR PERMI7 �"�r t-t� <br />' 7�- �l'�+� � <br />� h .2 r.- i s ��, :� <br />PRICE OF WORK <br />descriplionl <br />Y✓� 5 <br />Y�hP.YS�t <br />�Jt,on , P <br />Proposed Use of �uildinc� �"n" iv��� � � � w�' ' ' - � "- •,. <br />Duilding type: ,_ Single Famity _ Duplex _Townhouse _ Mulli-Family �Commercial <br />Type of projecC =' New _ Addilion _Remodel _ RePair _ T.I. _ Sign _Spnnkler _Demolilion_Change of Use <br />Destripli0n o( Wofk (addilional space prov�ded on fhe backJ : <br />(�,�r- t .� uT ��� � <br />you started working wilhout a permil7 _YES �/NO <br />iVIECHANICAL PERMIT APPLICATION <br />ol Project: _New _Addn _A��eration _Repalr <br />Show Number (N) of fixtures <br />G�s <br />R <br />henter <br />ING PERMIT APPLICATION <br />ot ProjecC _Now _Addn _Alteration _Repafr <br />Medical Gas <br />Other: <br />I Number ol Heatls -- - <br />I hereby �ertdy �hal I havu read antl e�ammed Ihis applicalion and know Ihe same lo be true and cortect. All proviions of law5 antl ortlinances goveming <br />tn�s type of work wiil be comp�ied �++th whether speciLed �erein or noL The granling ol a permil does not presume lo grve authotlly to violale or cancei <br />the provision of any olher slale or local law regulaticg construclion or the pedortr.�nce oi constmction. ihal I am authonzed by the ovmer ol this property <br />�o pedortn the work for wfiich applicalion is made and I comply with the State Contractore Law 7827 RCW and 296200 WAC <br />� ������� � ✓ �'� 3������ (Revlsed?/2011� <br />OwnedAuthorized Agent SI `StutO Date <br />/� <br />