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c <br />PERMIT APPLICATION <br />BUILDING/MECHANICAL/PLUMBING/SIGN/SPRINKLER/DEMOLITION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 Cedar St., Everett, WA 982U1 425-257-8810 FAX 425-257-8857 www.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />ennocec• PROPERTYTAXp PERMITt� �� <br />�-in// Gd�3Y <br />(or new construction: Short <br />Sr Eveac:. ����r w,4Y <br />No._ (attach copy uf long Iegai descriptlon) <br />�7/C/Zcl/ �,/A'- S%2dd� <br />_Owner _Owner'sAgeN ��Conlractor _ConiractofsAgenl Tenant�m�e�proNaa.ion�roicanumuommeow�onowwor�mma:p.�e) <br /># <br />Qj'27� IPhonelEmall ��.d ��� <br />GNr�m�+o �e' p„�� 2eJ7A-u� <br />PhonelE•matl <br />3UILDING PERMIT APPLICATION CONTRACT PRICE OF WORK �� <br />xisting Use of Building HEAT <br />'roposed Use of Buildir.g Gas_ Eii <br />iuildingtype: _SfngleFn�iiil� __Duplex_Townhouse _Mulli-Family _Commerclal <br />voeofproiect: _New _Addition _Remodel Repair T.I. Sign Sprinkler_Demolition <br />OF WORK (edditional space F�✓�ded on the back) : <br />MECHANICAL PERM17 APPLICATION <br />ofProJeel: _New_Addn _Alleralion_Repalr <br />Show Num6er (NJ of Ilxfures <br />AI[` — ai; handlino units <br />of Heads <br />COE <br />PL.UMBING PERMIT APPLICATION <br />ofProJect: _New_Addn _AlleraHon_Rapalr <br />Show Number fN1 of llxtures <br />Other: <br />Other: <br />Gas <br />I here6y certifythet I have raed and exemined this applica�ion and knawlhe same lo be irue end carted. All provisions ol laws and ordinences goveming ih�^ lype olwotk will be com�ed <br />vrilh wheNer specified hereln or not. Tha prentln8 0l e pertnX dces not presuma lo gNe auNwtty lo vblate or cancel Na provision ol eny ot�er elate a bcal law rcgulelinp conaUuclbn <br />Thel I am authodzed by �ha oxner ol lhia qoperty lo pertortn Ihe work for w10ch appliwtlon Is maEe and I compry wi11M No Slele Contraclon Lew 18.27 RCW anE 2%.200A WAC. <br />������ 7-/S -ZoYR <br />Owner/Authorized Agent Slgneture Date (Revisetl &2012) <br />