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�� ,�oostat�. <br />Ya������soodh��d5. PERMIT APPLICATION <br />BUILDING/MECHANICAL/PLUMBINGISIGNISPRIPIKL�RJDEMOLITION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 Cedar St., Everett, WA 98201 - 425-257-8810 — FAX 425-257-8857 — www•ever ttwa.or I <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM �` a�� I` <br />for <br />�I �l CC�V��' � <br />� Za� <br />p <br />PERMIT p <br />ac�,olSoo B�I��F- <br />Short PlaVsubdivision Lol No._ (attach copy ol long legal desu�ption) <br />i%�i, s��,/�/a �rl � PhonelE-mail �Zs 3`�7•ikl�� ��Y�t'Iody�Ql�StCl-K <br />LDING PERMIT APP�ICATIOM <br />Use of Building <br />0 <br />1 Y ��� <br />?RICE OE :^.�ORK <br />ProposedUseofBuilding l 1NV111tP V/ 1/4 1 v� ''`�' �"^'"` `I <br />Building type: _ Single Fa`m/ily _ Duplex _Townhouse _ Muiti-Family I.Commercial <br />Type of project: ,_ New x Addition _ Remodel _ Repair _ T.I. _ Sign _Sprinkler _Demolition_Change of Use <br />COvh(J \ F-{�iY� t ��,P O�� �-)O lA � <br />Desc�iption of Wo�k (additional space provided on the back): �/� tt ( Q` �1 <br />(j; 5� b`(V1 v1�.0 v( I(�l � LV't 1 P1� `�Cl � P <br />Haveyoustartedworkingwithoutapermit? �YES �`NO ��� n11.1`11�J��'1� �`L�11.� �i�Qj� � J��ii�'�n�!tI <br />u <br />PERMIT APPLICATION <br />ofProJect: _New_Addn _Alteration_Repair <br />Show Number (p) ol �xtures <br />A/C — air handlina unils <br />RES51 <br />Number of <br />PLUMBI G PERMIT APPLICATION <br />of Projecl: _New_Addn _Alleration_Repair <br />Medical Gas <br />Other: <br />I hereby ceAify �hat I have read and ezamined this applicalion and know the same to he We and correct. NI provisions of lav,s and ordinances goveming <br />this type of �wrk vnll be complied with whether specifed herein or not. The granling of a pertnil dces not presume lo give authorily lo violale or cancel <br />Ihe provision of any olher state or local law regulating wnstruclion or Ihe pedormance o( consWction. That I am authorized hy lhe o�mer o11h15 propeAy <br />to peAoim the wnrk for wfiic application is made and I compty vrilh the Stale Contractors Law 78.27 RCW and 296.200 WAC <br />� � 2�� u <br />� �.L � c� (L. l � � � -u1'\ ��--��� � (Revised 7/2011) <br />Owner/Authonud Agent Sgnature Dale <br />1 <br />