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( <br />( <br />PERM!'' APPLICATION <br />BUILDING/MECHANICAL/PLUMBING/SIGN/SP�INKLER/DEMOLITION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 Cedar St., Everett, WA 98201 - 425-257-8810 — FAX 425-257-8857 — www.everettwa.org <br />APFLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM 3- n a�� � <br />Ao�RESS: PROPERNTAXN P�ttMl��'�> ` �, <br />L lor new consWclion: Shart PlaVsubtllwslon <br />ER IJ�i� (y��.eclG� �- <br />,g �33 Sw ErexeEt Ma�-� E�'-/ <br />'RACTOR O�ViP� ���r'iwti` � ��5( <br />:s �7u?-u sw E�vb( F�ta�C �t'2"'( <br />,NT BUSINESS NAME <br />jr� `�' �� <br />LDING PERMIT APPLICATION <br />No._ (attach copy of long Iegai descriplion) <br />il <br />P <br />PhonelEmail �}��(y�'U -`-�75 <br />' FOR PERMIT <br />,,� (4as) c�ic�-�t75�j <br />PRICE OF WORK <br />Exisling Use of Building �% • '-- -- <br />Proposed Use u( Building��r[S'� ��'an �� Gas Electric_ Other_ <br />Building type: _ Single Family _ Dupiex __Townhouse _, Multi-Family � Commercial <br />Type of pro�acl: _ New _ Additiun _ Remodel _ Repair _ T.I. _ Sign _Sprinkler _Demolition_Change of Use <br />De�cription of Work (addifional space p/ovided on fhe back): <br />��joc,er ove� exh�s+�r.c� rco� a+-�d �--Sk`n�� <br />you started working without a permit? _YES ,�NO <br />MECHANICAL PERMIT APPLICATION <br />ofProJect: _New_Addn _Alteratlon_Repair <br />SYSTEM <br />PLUMBING PERMIT APPLICATION <br />o}ProJect: _New_Addn _Alteralion_Repair <br />ShowNumber(M)o/Oxturas _ <br />Medical Gas <br />Other: <br />Other: <br />I hereby certify that I have read and examtned Ihis appllcation and know the same lo be liue and carrecl. All provislons of laws and arclinances govemtng <br />this lype of work will be wmplied with whether speci�ed herein or not. The granting ol a permi� does not presume lo give authority to vlotale or cancel <br />the provision of any olher sl;.le or local law regulaling conslruction or the pertormance of construction. Thal 1 em aulhorized 6y lhe owner of ihis propeAy <br />to peAortn Ihe work for which applicalion fs mad� d I comply with the State Contractors Law 18.27 RCW and 296.200 WAC <br />-�---- <br />3-Z-1/ <br />pwrler thorizedAgentSignature Dale (Revised22011J <br />