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�. <br />� <br />PERMIT APPLfCATION <br />BUILDING/MECHANICAL/PLUMBING/SIGN/SPRINKLtRIDEMOLITION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 Cedar St., Everett, WA 98201 - 425-257-8810 — FAX 425-257-8857 — www.everettwa/.or <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM II/ O�'/ <br />for new consirucllon: Shart <br />U� <br />3' <br />BUILDIWG PEFtMIT APPLICATION <br />tt ��z�oso�oo 306 I oo I�Wl��l I I 0= <br />Lol No._ (atlach copy of long legal descripllon) <br />Phone/E-mail 2,5�'— Z ^ <br />(� CilylSlale/Zip /��eir,t� G<-�fl /(p0,j C� <br />� L&ILic.# <br />PhonelEmail 7,Q 3� ���/ <br />CONTACT FOR PERMIT <br />PhonelEmall � �`'� <br />CONTRACT PRICE OF WORK �O� � <br />°xisting Use o( Building i�U'�i//%�fi6r� HEAT SOURCE: <br />'roposed Use of Building CcmQ��C� Ges x Eiectric K Other_ <br />3uilding lype: _ Single Family _ Duplex _Townhouse _ Multi-Family i� Commercial <br />fype of project: _ New _Addition _ Remodel _ Repair�,T.l. _ Sign _Sprinkler_Demolition_Change o( Use <br />)escription of Work (addifional space provided on the back): <br />-Z�ilf�ci� Cc�'JLtQ�tl,y/7F�lvnt�Jct11 i`cx� Mocc� (J.Ut%S ��( / <br />.z,,.�u.2� c��t(K—ii� %7".tx�-I �no/�� i4); l�,Pr� D�1 ca.�; �m�cu'��I�'� <br />�ave you started working without a permit? _YES � NO �� f��.� �/�SS ���1 ��Q�Q�/ �� � <br />MECHANICAL PERMIT APPLICATION <br />o( ProJoct: bNew_Addn _Alloration _Ropalr <br />ShowNumbcr(q) alfiztures <br />A/f: — air hanrllina unils <br />Boiler <br />/ <br />BING PERMIT APPLICATION <br />ofProJnct: _Now_Addn _Alleretion_Rapalr <br />Show Number (!!) ol /Ixfures <br />sink <br />Flaor <br />Mediral Gas <br />Other: <br />Other: <br />I hereby certify Ihat I have rnad and examined this application and know the same to ba Iruo and correct. All provisions of laws and ordinances governing <br />lhis type of work will bo complied wi�h whelher specified hereln or noL Tho granting of a permil does nol presume �o givo aulhonty to violaie or cancel <br />the provision of any olher slale of local law regulaling conslrucllon or Ihe pertormance ol conslruclion. Thai I am aufhorized by the owner of ihis property <br />�o pertorm Ihe work for which applicatlon is made and I comply wilh Ihe Slale Contractors Law 18.27 RCW and 296.200 WAC <br />rF�t� flil /�/t �%��20/� <br />OwnarlAuthorized Agont Slgn ro Date (Revised 22011) <br />�iue. <br />1/a <br />