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� <br />a <br />PERMIT APPLICATION <br />BUILDENG/MECHANICAL/PLUMBING/SIGN/SPRINKLER/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 />�� ��L.P�'�— APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 rM ���`�� <br />ADDRESS: _ , ^ 0 PROPERTYTAXk A�RM�T'1A�J—n1 <br />tor new conslruction: Short <br />PERMIT APPLICATION <br />Use of Building <br />No._ (allach copy of Iong legal description) <br />PhonelE•mait <br />8 I Lic. # <br />PRICE OF M/ORK <br />?�iq- � <br />G �a�B , v5w. <br />��z� <br />HEAT SOURCE: <br />�sed Use ot Buiiding � oas_ �iecmc_ �!wci_ <br />ng type: _ Single Famiiy ,_ Dupiex Townhouse __ Multi-Family _ Commercial <br />of project: _ New _ Addition _ Remodel _ Repair _ T.I. _ Sign _,Sprinkler _Demolition_Change of Use <br />�iption of Work (addifional space provided on (he back): <br />�� �� ��� <br />yousWrtedworkingwllhoutapertnit� _YES_NO <br />MECKANICAL PERMIT APPLIa.ATION <br />ofProJecl: _New_Addn _Altoration_Repair <br />Show Number (#) o/ fixtures <br />SPRINKLER / <br />of <br />SYSTEM <br />PLUMBING PERMIT APPLICATION <br />ofProJect: _New_Addn _Alteratlon_Repair <br />Medicai Gas <br />Olher: <br />Olher. <br />I hereby cerliry that I have read and examined this application and knaw the same to be true and cortect. All provisions of laws and ordinances goveming <br />this type of work will be camplied with whelher specified herein or not. The granting of a permil does not presume to giva aulhorily to violate or cancel <br />Ihe provision of any other slate or Iocai law regulating consiructlon or the perfortnance of conslruclion. That I am aulhorized 6y the owner of ihis property <br />to pertorm the work for which applicatlon is made and I comply wilh Ihe State Conlractors Law 18.27 RCW antl 296.200 WAC <br />�� /l�%�%/%/% _ -- <br />Ow IA�tlforiz en fgnal � Date (Revised2/2017) <br />