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� <br />� <br />PERMI� P►PPLICATION <br />BUILDING/MECHANICALIPLI;MBINGISIGN/SPRINKLER/DEMOLITION <br />CITY OF EVE�ETT PERMIT SERVICES � �E�...� r <br />3200 Cedar St., Everett, WA 98201 - 425-257-8810 — FAX 425-257-8857 — www.evere a.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />I SID 5C Eveieff f�1cl� <br />tornewconsWction: ShoA <br />�N r.LC <br />t /�irC 5�, {e %3b <br />t�-o. 8ox 32oS <br />Ci" ��� l�'S <br />a�rd C'oo��n��l� <br />� r kl ae�, Gu�.! . 95 o fi 5 <br />BUILDING PERMIT APPLICATION <br />siRoo��ob aaa <br />No._ (atlech copy of lonp legal descrip(ion) <br />S�ti{fl� / G <br />C FH�Phone/Email 72 J' <br />ORPERMIT Te��n <br />.� <br />va,-Szi-re13 � <br />PRICE OF WORK <br />y� `(P>�01 <br />q C!7 <br />2l-/z53 <br />.UJoelle� <br />re my(a' Cfn.-�ivc:cr, �or� <br />ng Use of Building 1 ,,�/+ HEAT SOURCE: <br />75ed USe Of BUildin9 Q�1�L+1 CJtt" tC �Q Gas� Elednc Other <br />ng type: _ Single Family _ Duplex _Townhouse Multi-Family � Commercial <br />ofproject: _New _Addition _Remodel _Repair X T.I._Sign_Sprinkler_Demolition Change ofUse <br />ipti0n o( Work (eddifionel spece provided on fhe 6ackJ: L(1S� A I � �1 C�V d� ['f" W e✓ �C nnel g�<«<S '�"D Q f� L°A i 3 f�� n f <br />{'�oQ un;�, ib) ex�a�s�{'ans,(I) �reSHa�� �ouvtr� c�,��(I) c�ryei uev�%. <br />you started working without a permit9 _YES _NO <br />MECHANICAL PERMIT APPLI <br />ofProJect: _New_Atldn <br />Number <br />PLUMBING PERMIT <br />ofProject: _New_Adtln _Alteretion_Repair <br />Show Number (p) ol Rxtures <br />Medical Gas <br />Othec <br />I hereby cetlily that I have read and examinetl this application and know Ihe ume to be Irue antl wnect. All provisions of laws and oMinances poveming <br />this lype ol v.ork vnll be wmplied with whether specified herein or not. The granling af e permi! doe, not presume to pive euthonty lo violele or cancel <br />the provision of any olher stete or lowl law regulating wnstruction ar Ihe performence of wnstruction. Thet I am authorized 6y the ovmer ol this property <br />to perfor e work forwhich applicalion is made and I comply v,ith Ihe Slete Contrectors Law 18.27 RCW and 296.200 WAC <br />�G�l/� ���/�`�GGt-1 �I�'DIJ'��� <br />O rlAwn�orized�e�5igneture Date <br />(Ravised?llot t) <br />