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PERMIT APPLICAi'ION <br />BUILDINGIMECHANICALIF�LUMBING/SIGhIISPRINKLERIQEMOLITION <br />CITY OF EVERETT PECtMIT SERVICES <br />3200 Cadar St., Everett, WA 98201 - 425-257-8810 — FAX 425-257-8857 — www.everettwa.org <br />APPLICATIONS ARF ACCEPTED FROM B AM TO 4 PM �'"��I� <br />PpCPERNTAXR P TN�7 <br />ADDRESS: j� IC /_p�����Wvn�v I I Ull4 _ � `� <br />! J H/ <br />for new construction: Shod PIaVs�W ivisian Lol No._ (altach copy ol long legal descnplion) <br />� lT��c -L?�NH' J�NG PhonGE-mail �D�D 33y-5g� � <br />G� <br />Bl71LDING PERMIT AP'.'LfCt.T20N <br />N'�� L&ILic.# ,��J:f'rJ `t�aKT <br />'N W "a� Phonel[mail 3 � � - � � � - � �' S <br />f7 % <br />CONTACT FOR PERMIT / �1 <br />� . P�one/E-mail �� � l �� 1 —h � � � <br />CONTRACT PRICE OF WORK % OD �( <br />ng Use of Building F� +2N �TJ� E$T��� HEAT SOURCE: _ <br />ised Use of Building A�1�l2kE� Gas Electnc_ Other_ <br />ng type: __ Single Family _ Duplex _Townhouse _ Mutti-Family � Commercial <br />ofproject: _New _Addilion _,Remodel _Repair_T.1._Sign_Sprinkler_Demolilion�Change ofUse <br />�iplion of Work (additional space pmvided on fhe back) � <br />you started working wilhout a permit? _YES �NO <br />MECHANICAL PERMIT APPLICATION <br />ofProJecl: _New_Addn J Altcra0on_Repair <br />Show Num6er (N) of Ilxfures <br />' I [VC-airhandlinuunils <br />SYSTEM <br />PLUMBING PERMIT APPLICATION <br />ofProJecL• _Now_Addn �Allerallon_Repair <br />ShowNum6erfklo/flztures _ <br />Medical Gas <br />� I Other. {�-'f(00t $11\ <br />I hereby cetlity ihat I havo reatl and examined lhis application and know the same to be irue and correcl. All p:ovisions ol laws and crdinances goveming <br />this rype of wek wiil be wmplied wilh whether specifed herein or noL The granting ol a permil does nol presume to give authonty to violate or cancel <br />Ihe provision ot any olher slale or local law regulating conslruction or lhe pe;formance of consWction. That I am aulhonz^d by the owner ol this properry <br />lo peAorm Ihe work l�or whth7 appli atpn is made and I compty wilh Ihe State Coniraclors Law 1827 RCW anC 298.200 WAC <br />/r'�I �C ` �.,�, /�l � <br />� �� r �' (Rev!sedv2oii) <br />OwnedAuthodzed'hJenl SIg iature � Dale <br />