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�, <br />� <br />� <br />s <br />_ i_ <br />� <br />d <br />PERMIT APPLICATION <br />BUILDING/MECNANICALIPLUMBING/SIGNISPRINKLERlDEMOLITION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 Cedar St., Ev2rett, WA �J820 i- 425-257-8810 — FAX 425-257-5&57 —t•n�r�v.everetn:�a oro <br />APPLICATIOAJS ARE ACCEPTED PROi�7 6 AGi TO 4 Pi:i y <br />I7E ADDRESS: FROF�FrvTax u <br />_ yRO� Dove2 ��}✓� o�sti9 �{o i�o r 3v �`�;1'iT�nc� -0? <br />L[GALicrne�rwnstn:cton Sr,crt <br />� c�5 <br />BUILDING PERR9IT APPLICATION <br />No (ztlach cc;y o' Icr IE9al tlescnpLon) <br />u��_ 2�l�-vo-�_-� <br />RryiSt.:;c.'Zip <br />FhC �_ cma'I '"'T7i� <br />RF.C7 PRICE O'r <br />Pj(L4'L4nl %�si+JCG! <br />ex��.et!-,: Us= o! B�.:iid�ra _______ H"eAT SOURC'e� <br />?rc,:osc9U�ee`Bui�d.nc Gas___ [�cctrk__ O:r.c� <br />E3�,�i ;�ngtype�. _SingleFamily _D�piez_Tormhcuse _�.iulti�Famlly _Com���e;ciai <br />Tyro of prcect: Ne�v _Add�tion _ Remodei _ Repair _ T.L _ Sign _Sprinkler_Demeld�onf' Chenge o,' Use <br />Ch,�riptierofVdork(etld�hena!scaceproviticde�fr.oLa�k): REO(�i� �S77�q lJ(iL�L'( Vi�1V'% �S �i <br />WR'T�2 �TA-�/K U/tT7i ii- N�Frn1 E7�TZNR'L T.q-r,1K�55 G-�FS !-iaT GUA?'�1C— <br />l{ P�T�Z_. <br />liave you �tzrled �vorking withou[ a permit? �YES __NO <br />h7ECHANICAL PERMIT APPLICATION �—PWP.7BIfJG PERfviIT APPLICATIOP7 <br />otPto�2ct _Nca_Addn _tJ;cralion�Fepair <br />Gas <br />NKLER/ <br />--a�r <br />ot H=_ztls <br />eiProject _Ne,::_Addn /2(ARva;ir,n_ Rcp�ir <br />SIIo�VNumbVl=1 o`fiatu�rr: <br />Mediwi Gas <br />Other. <br />Other: <br />I h:r�py ee�uy tnat I have read antl e�vminetl Ih� ; app'�,o3L'on and knG.r the _.R�E lo hf Uue:,ntl GOftKI All provisiCnS o(13v5 and ord�nznces govcr�r,; <br />tni; rype ol work vrll he compl;ed ai,h ��heV�er;pcdfed hercin er rot The grznGng ol e pertnit doe5 not presume to pive a�lhority to eio�a;e or W nccl <br />� me provision ef any other,tate or la�l law regulaGng censtvcllon or t`e pedormance ot mrs Wction. That I am av7hcrL•ci t; t•�,c c,c�,cr e' Ui s F��F�"Y <br />to pc�t U:e �wrk torohich zpp!iceGon Is made and I comply HiN ihe tate cnUaclor L2w 1627 RCW an0 2�6.200 6VAC <br />��� f�� _ 9���� <br />��,e: scd z2oo r, <br />