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( <br />PERMIT APPLICATION <br />BUILDING/MECHANICAUPLUMBING/SIGN/SPRINKLERIDEMOLITION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 Cedar St., Everett, WA 98201 - 425-257-8810 — FAX 425-257-8857 — www.everetlwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM %��� �. ( <br />for new conslruction: Short <br />Cv�tuaoa�w5'� <br />E2 caaMt�a� <br />BUILDING PERMIT APPLICATION <br />Use of Building <br />rnx a I <br />�, No._ (al(ach copy of long le� <br />ai� 3 �q `�� <br />�p G4 °157Sf� <br />descdplion) <br />i � 's�s <br />�� �- — _: <br />PRICE OF WORK <br />�+acN `T�.�rz�' F' <br />Proposed Use ot Building � '— - - — <br />Building lype: _ Single Family _ Duplex,_Townhouse _ Multi-Family � Commercial <br />Type of project: _ New _ Addition _ Remodel _ Repair �.JI. _ Sign _Sprinkler _Demolition_Change of Use <br />Description of Work (additional space provrded on Ihe back : �1'M1 '��1M�'31t�- �� 1� ��� ��''�-7 <br />1�1P�,1 V�L' `�l-UD w9�wS W1�v.st� �'o" r t�a�.o CC�LInx�- dRto ���� C�)SA�rz. <br />�� �a2� C$�'��+'�- f��°��s � +��►4s t �+1.�-z'• 't.1� �► �s+l�' �.''� <br />Have you started work(�±g without a pertnit9 _YES �NO ��,pB��-: �iG'� �Ghi�� R�� V�N�1� <br />MECHANICAL PERMIT APPLICATION <br />ofProJect: _New_Addn _Alteratlon_Repalr <br />Show Number (A) o//lxfures <br />PLUMBING PERMIT APPLICATION <br />o( ProJaet: _New _Addn _Altention _Repalr <br />ShowNumbe�f#1 o/flxtures <br />Medical Gas <br />Olher: <br />� I Number of Heatls I I � ""'�'. <br />I hereby certify Ihat I have read and examined ihls appllcalion and know Ihe same lo be in�e and cortect. AII provlsions of laws and ordinances goveming <br />Ihis typo of work will be complled with whether specified herein or not. The grantfng ol a permil does not presume to give authority to violale or cancel I^ / <br />the provislon of any other state or local law regulating consiructlon or the pertormance of conslNction. That I am aulhorized by ihe owner of Ihls property -�/ <br />to perform the work for which applicallon Is made and I comply with the Stale Contractors Law 18.27 RCW and 298.200 WAC \ <br />1 <br />�' 2a <br />wnerl IzedAgen Slgnalure ` Dale � (Ravised7/2011) <br />�� <br />