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� <br />� PERMIT APPLICATION <br />BUILDING/MECHANICAL/PLi1MBING/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 />APPLICATIONS ARE ACCEPTED FROM B AM TO 4 PM S- 3O �(� <br />TAX Y <br />�1" <br />for new consWclion: Short Plat/subdivision________________-_____�ot No.__ (atlach copy of long legal de: <br />� � 9 Phone/E-mail Lrz� ,��� � (U L-� <br />� J�.�Q`� SIi�.C.�"�'4 i "1 1"�lTl�l `' �/ <br />.�r.�..- � 1.:�9.'i . �., :!.' %o � n� � (lioistate2fo l/i:'-F./`t' 1-7- �.f-1'�} <br />I Lic. # <br />���1`��'lC.�!''t L,�`ij!f <br />IG PERMIT APPLICATION <br />Use o( Building <br />PRICE OF WORK <br />�sed Use of Building_ ___—__-____________ I �as____ tiecmc_ __ �mer_ _. <br />ng type: __ Single Farnily __ Duplex _Townhouse __ Multi-Family ,� Commercial <br />of project: _ New __ Addition __ Remodel _ Repair ___ T.I. � Sign ___Sprinkler ___Demolition___Change ot Use <br />�ip�ion of Work (addifional space providetl on the backJ : <br />��.5� Ct_CC C?v,�� l,c��' C,i��C��C� ,�� �� )��� <br />you staRed working without a permit4 __VES ___NO <br />MECHANICAL PERMIT APPLICATION <br />ot ProJect: ___New ___Addn __ Alteration _ _Repair <br />ShowNumberlpl o(/ixW�es <br />SPRINKLER <br />o( Heads <br />SYSTEM <br />PLUMBING PERMIT APPLICATION <br />of Project: __New _ _Addn __ AlteraHon __Repafr <br />Medical Gas <br />Other. <br />I hereby certify �hat I have read and ezamined lhis application and know the same to be irue and cortect. All pmvisions ol lavrs and ordinances goveming <br />this type of vrork will be complied with whether specified herein or noL The granting of a permit does not presume lo give aulhodly to violate or cancel <br />ihe provision ol any other stale or lowl law regulaling constmction or Ihe peAortnance ol construclion. That I am aulhorized by the ovmer of this propetly <br />b rm �he work lor which applicalion is made and I comply with lhe Slate Contraclors Law 7827 RCW antl 296200 WAC � <br />fF ( <br />11l �l��i''� �/i�/�J �� <br />O�IAut�zed Agent Signaturo Date (Revised 2/2011) <br />