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PERMIT I�PPLICAT'ION <br />BUILDING/MECHANICALIPLUMBING/SIGNI:�PRINKLER/DEMOLITION <br />CITY OF EVERETT PERMIT SERb`ICES <br />3200 Cedar St., Everett, WA 98201 - 425-257-8810 — FAX 425-257-8857 —www.everettwa.org Z <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TG 4 PM � <br />)DRESS: G� i- — PROPERTYTA%p P RMITp l��.y <br />7J � '.i P11 Q �i T� <br />for newwnslructlon: Short PlaVsubdivision Lol No._ (altach copy of long legal desaip�lon) <br />�NT BUSINESS NAME CONTACT FOR PERMII ��U•,q K <br />A sl �� i� L�Y'�G�t" PhonelE•mail � . G� ���. <br />LDING PERMIT APaLICATION coNiRncTPRICEOFwoRK /600 <br />HEAT SOURCE: <br />ng Use of Building <br />Gas_ E�eclnc_ Other_ <br />�sed Use of Bullding <br />ngtype: _SingleFamily _Duplex_ Townhouse _Multi-Family _Commercial <br />ofprojecl: �,New _Addilion _Remodel _Repatr_T.I._Sign_;Sprinkler_ Demolition,_Change ofUse <br />riplion of Work (atldifional spaco provlded on fhe backi : <br />Ncu� UL �oe ��r� Sc�!''j'i�SSi� <br />� you started working wilhout a permlt? _YES �10 <br />MECHANICAL PERMIT APPLICATION <br />ofProJecl: _New_Addn _AtleraUon_Repair <br />ION <br />s�,��,� T k oaa <br />PLUMBING PERMIT APPLICATION <br />ofProJecL• _New_Addn _Alteratlon_Repalr <br />Medical Gas <br />Other: <br />I Number of Heads ' <br />I hereby cerlify thal I have read and examined lhis application antl know Ihe same to be Irue and correct. All provisions of laws and ordinances goveming <br />this type of work will be complied vrith whelher specifed herein or not. Tho granting ol a permit does not presume lo give aulhorily to violate or wncel <br />the provislon ol any olher stala ur laal law regulating wnsiruction or the pertormance of consWction. That I am authorized by lhe mvner ol lhls pmperty <br />to peAorm ihe work fcr which appli a0on is made and 1 wmpty vnlh the State Contrectors Law 18.27 RCW and 298.200 WAC <br />/' : ]�.?p .2u�2 <br />i (Revised 7/20f il <br />OwnerlAuthodzed Agent S) naWre Dale <br />✓ <br />