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PERMIT APPLICATION <br />BUILDIIVGIMECHAf�lICAL/PLUMBING/SIGNISPRi�VKLERIDEMOLITION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 Cedar St., Everett, WA 98201 - 425-257-8810 - FAX 425-257-8857 -www•everetiwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM S�I �—�� <br />PROPERTYTA%a PERMIT# �� <br />ADDRESS: � � .0 <br />�, ����� wa � <br />,L (or new construction: Short PlaVsuhdivision _Lot No._ (altach copy ol long legal tlescription) <br />2l <br />v <br />o�.JTwrl <br />&ILic.# <br />zo�-GSd -s�3 <br />fENANT BUSINESS NAME CON`fACT FOR PERMIT o� ��„� Y.��O <br />�.u� �sN6b�l-i <br />FVT�IESS �Y��-vY�f',' Phcn_lE�mail i� -7 i- �et ���� <br />BUILDING PERMIT APPLICATION CONirtAc7PRICEOFWORK_ ���'� �C � <br />ExislingUseofBuilding GYNI HEATSOURCE: �KI T1rJ <br />�v�� � Gas_ Electric_ Other_ <br />Praposed Use of Building (a YM �--T— <br />Buildinglype: _SingleFamily _Duplex_Townhouse _Multi-Family�Commercial _ <br />Typeofprojecl: _New _Addition _Remodel _Repair_T.I.�Sign_Sprinkler_Der,olition_Change ofUse <br />Description of Work (addifional spaca providedan Ihe 6ack�: ^ � ���N�,Q 9� <br />IN$TA.I..�_ .ts i.£'MYr�)`-9�Y SgI.E?' S�iSt-G ✓ �� t s �.a�s-CYr+-+�T.CG . <br />r„�c spocE �,.�,u.. -�E �-r�wvr� o�ic� r��.., 4rM (s�T ) <br />Have you started working wilhout a permit7 _YES�,NO <br />MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br />TypoofProJecl: _New_Addn �Allerallon_Repalr <br />snawNam6e�lkl olllzfums <br />LER <br />ofProjeet: _New_Addn _Alterelion_Repalr <br />showNumbcr(p)o/flMures _ <br />Medical Gas <br />Olher: <br />a,��'f(1�(� NumberofHeads � � � Other: <br />I hemby certiy ihat 1 havo read and examinetl this apPlication and know Iho same to he Irue and correct. Ali provisions ol laws antl ordinances goveming <br />Ihis type ol work eriil b: complietl vnth whether specifed herein or not. The granling ol a permlt does not presume l0 9ive authority to violate or cancel <br />Ihe provision ol any olher state or local law regulaling constmclion or Ihe pedormance ol construction. That 1 am authorized 6y Ihe ovmer of lhis pmperty <br />to pedorm tho vrork for �vhich appiication is mado and I compty vrith tho Sta� CoNr etors Law 18.27 RCW and 296.2�0 WAC <br />- 1 � �vV I � (Revised 7/2011) <br />0}vnc Aulh ri¢� �Jent SlgnaWro alc <br />\ <br />E <br />1� <br />Z <br />