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PERMIT APPLICATION <br />BUILDINGIMECHANICALIPLUMBING/SIGN/9PRINKLER/DEMOLITION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 Cedar St., Everett, WA 98201 - 425-257-8810 — FAX 425-257-8857 — www•everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PPA �- o-i 7 II <br />PROPERTY TAX N P RMIT # n <br />SITE ADDRESS: _ ,, i• Q �� '�� � � OLJ �O� <br />for new conslruction: Short <br />5 <br />BUILDING PERMIT APPLICATlON <br />Use of Building <br />No._ (attach copy of long legal description) <br />PhonelE-mail 2r".55.� ��: <br />«��� CirylStale/ZIPC�lel�ll L <br />L .1;.� �.c. L & I Lic. # <br />�'Fwc..S i�A y825 5 Phone/Email � 2 <br />CONTACT FOR PERMIT <br />Phone/E-mail <br />CONTRACT PRICE OF WORK <br />!� <br />Proposed Use oF Building utt � <br />Building type: ,_ Single Family _ Duplex _Townhouse _ Multi-Family � Commercial <br />Type of project: _ New _ Addition � Remodel _ Repair _ T.I. _ Sign _Sprinkler _Demolition_Change of Use <br />DesCfiplion of Work (addifional space provided on fhe 6ack): <br />you started worhing wilhout a permit7 _YES _NO <br />MECHANICAL PERMIT APPLICATION <br />of ProJocL• _New_Addn _NtoraUon_Repalr <br />Show Numbcr (N) ol Iizfures <br />i nic — air handlinq units _ <br />SPRIN <br />SYSTEM <br />PLUMBING PERMIT APPLICATION <br />otProJoct: _Now_Addn _Alteration_Rapalr <br />chnw Numheflpi o( IIXf11lCS <br />Medical Gas <br />O�her: <br />I Number of Heatls - - <br />I hereby cetlify Ihal I have read and examined this application and know th� same lo be Imo and correcl. All provisions o( laws and ordinances goveming <br />ihis lype of work will he complied wi�h whether specified herein or noL Tho granling of a permil does not presume to give aulhority lo violale or cancel <br />Ihe provision ol any other slale or local lav� re9ulaling constmction or ihe perlormance of conslruction. That I am authorized by lhe owner of Ihis property <br />to pertorm the work forwhich applicalion is niade and I comply wilh Ihe Stale Conlractors Law iB27 RCW and 296200 WAC <br />� <br />C.��•o �' �J` „�t�� � -27- zd ! I <br />OwnodAulhorizod Agont SlgnaWro <br />Da�e (ftevised 22011J <br />