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' \ <br />, -.. y <br />PERMIT APPLICATION ;�-�,�� �= " �` `—�'�� <br />\\ . . �. �, <br />BUILDINGIMECHANICAL/PLUMBING/SIGN/SPRINF�L�RIDEMOLI�'ION <br />CITY OF EVERETT PERMIT SERVICES ��, r„�;il �'�'�''�.1i��aj <br />3200 Cedar St., Everett, WA 962M - 425-257-8810 - FAX 425-257-8857 �' �everettwa.org <br />rJ�I � APPLICATIONS ARE ACCEPTED FROM B AM TO 4 PM /�6—/U <br />ADDRESS:.� ^� S+W EVeVe�' �Y%q,J� <br />��Lrf <br />p <br />� <br />for ne.v consVuction: Shon PlaVsubdivisian Lot No._ (attach copy ollong lepal description) <br />i i iAv9�i�l/l Phnna/F.mail <br />l � �os Ca�'' �Q'�G <br />croR S �q h T�C.I.� <br />S`//3 �G1J�/L Z <br />BUILDING PERMIT APPLICATION <br />Use ot Building <br />d Use of Buildin <br />G �siu�.a S lC <br />/ r^� � PhoneJEm <br />CON7ACT FOR PERMI <br />PhonaJE•mail �L� <br />TEL �'! `6r5 t`5 <br />Z S3 �Z2 Z � <br />C <br />PRICE OF WORK <br />l <br />HEAT SOURCE: <br />Building typo: _ Single Family _ Duplex _Townhouse _ Mufl�-Family _ C�mmercial <br />7ype of project: _ New _ AddRion _ Remodel _ Repair _ T.I. � Sign� !Sprinkler _Oemolition_Change of Use <br />Description of Work (erldrtionel space providod on Ihe beck): �- <br />� cUb�n�t si9n <br />Heve you started working without a permit9 _YES _NO <br />MECHANICAL PERMIT APPLICATION <br />ofProject: _New_Addn _Alhration_Repalr <br />Gas <br />/ SUPPRESSION SYSTEM <br />PLUMBING PERMIT APPLICATION <br />oiProJect: _Now_Addn _Alteratlon_Repalr <br />ShowNumbeilMl alfixtures <br />BackAow pre <br />Urinal <br />Driniting Fou <br />Floor drain <br />Grease irap <br />Roof drains <br />Medical Gas <br />Other: <br />Other: <br />I hereb� cenity thal 1 have �cad and examined this applinoon and knrnv thc samc lo be tma and wrred Pll prwisiorr al la+s and ordinances gmeming <br />Ihis typo ol v.oik will be compfiM Hith wfiether sppolied herctin or nN. The grantinA of a peimd daes nol preswne lo give aNhority !o vidale ar wncel <br />Ihe prwision o1 any o�er stale or lowl I� reAula�np conslluclion or the peAormance of constmdion. Thal I am authonzed hy the owner ol this praperty <br />to pcAorm thc ik lor whic pin6an is madc and I compy v.ith Ihe Statc Conhadars Law 1 B.Z7 RCW and 296200 WAC ,/�., _ <br />p{ �� <br />c�� ll- l�-I � <br />OwnerlAuthorized Apent Signature Date (Revlsod 1/201 Q <br />\/Z <br />