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( <br />PERMIT APPLICATION <br />BUILDING/MECHANICALIPLUMBING/SIGNISPRINKLER/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 />APPLICATIONS ARE ACCEPTED FROM 8 AM T04 PM 7—a-8� <br />for new construction: Short PlaVsubdivision______ Lot No._ (attach <br />&ILfc.# <br />�f OcU3 <br />�� �.,,�.�� <br />se� �5�� �' �- <br />PERMIT APPLICATION <br />Use of Building <br />PRICE OF WORK <br />of long legal descriplion) <br />�sed Use of Building I ""'—__ ""'"'"— ""."'_— <br />ng type: _ Single Family ___ Duplex __Townhouse __ Multi•Family _ Commercial <br />of projecl: __ New _ Addition _ Remodel __ Repair __ T.I. � Sign __Sprinkler _Damolition_ Change of Use <br />Descriplion of Work (addiNonel space pravided on fhe backJ: <br />v►��fi�P � U � �'� <br />Have you started working wfthout a permit? __YES �NO <br />of ProJec4 _New __Addn _Allaratlon _Repalr <br />, ShowNumberlA)olpxfures <br />ON <br />PLUMBING PERMIT <br />of Pro�ect: _Naw _Addn _Alteretlon _Repair <br />Show Numberlpl o/flxfures <br />Medical Gas <br />Olher: <br />I hereby certify Ihat I have read and examined Ihis applicalion and know Iha same to be lrue and conect All provisions ol lavrs and oidinances goveming <br />this typa ol vrork wll be complied wilh wfiether specifed herein or nol. Tha granting of a permit does nol presume to givo authority lo violate or a�ncel <br />the provision of any olher state or local law regulatin9 construction or Ihe peAormance of constiuction. That I am authorized by the owner of this property <br />to pe i he vrork for Hliich application is made and I comply with the Stale Contractors Law 1827 RCW and 29�.200 WAC <br />�l�'�1 <br />ulhodzad gent Signature �ate (Revised 2/2071) <br />'1 " <br />