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PEFtMIT APPLICATION <br />BUILDINGIMECHANICAUPLUMBING/SIGNISPRINKLER/DEMOLITION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 Cedar St., Evereri, W A 98201 - 425-257-8810 — FAX 425-257-8857 — wv�v✓•everettwa.or�_ � <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM PE�I � �� <br />SITEADDRESS: 1 ' PPOPERTYTA%N � _-� <br />� t li> <<i Lvc�L� �3'4.c,�/ L''`t u - <br />for new cronstruction: Short PlaVsubtlrvision_ <br />: �-r� �`(c �s, ;F cp....�-vc.c� <br />l`6 i c�0 Vov Kc��._c..-- <br />S[;;�G <br />� r �.,, <br />4ddress �QjSC'S� ��- 1Z4��` S <br />I CIYMI� 1 o��a���rrv ......._ //""�� <br />31�: I��cI:L� �1 �L` ; `:r��'' 1 <br />BUILDING PER(NIT APPI.IGATION <br />CirylStatelZip <br />81 <br />�w� <br />_(atlach copy of �org legal description) <br />Sif�� �`i��- �eCS' 11�'�� <br />i I /'� <br />i i, �,.,.� C .4.1 k _ <br />y25. �Z7�4 Z.G�L, <br />�rt r�nmu�l � <br />S.4.ww i <br />iCG•n. gZ7 `Z z�, L <br />�/2.1 — <br />PRICEOFWORK �rl� LW <br />ci� t � HEATSOURGE: <br />Eaisting Use of Building � <br />;Z C y� ` Gas} Elec✓ic Olher_ <br />Proposed Use of Building � <br />Buiiding type: _ Single Family _ Duplex_Townhouse _, Multi-Family _ Commercial <br />Type ol project: _ New _ Addifion _ Remodel _ Repair _ T.L _ Sign _Spnnkler _Demolition_Change of Use <br />Descriotion o( Wo�k (additional space provided on fhe back): <br />Have you started working without a permlt7 _YES _NO <br />MECHAMICAL PERMIT APPLICATION <br />ofProJocL• _New_Addn _Altoratlon_Rapair <br />Gas <br />Other <br />PLUMBING PERMIT APPLICATION <br />ofProject _New_Addn _A��eralion_Repalr <br />Shower <br />heatcr <br />Medical Gas <br />o�ner: f xt�-^�' se� <br />Other' �kf' <br />�i Number of Heads . <br />I hereby c ify that I have read and ezamined Ihis application and know the same 10 be tme antl conect. Ail pmvisions of iavs and ordinances governing <br />Inls typ ol rk will be wmplied vnth whether speci0ed herein or no:. The g�anting ol a permit daes not presume to give aulhority to violato or wncel <br />the pio isio of any other state or local law regulaling consWction m lhe pedormance o� construclion. Tha: I am authorized by lhe owner of lhis pmperty <br />��'ned rtn t e work tor which application is made and I comply vrilh the State Contractors Law 1827 RCW and 296.20� WAC <br />Agent <br />(Revised D2017) <br />�b <br />rw � <br />