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PERMIT APPLICATiON <br />BUILDINGIMECHANICALIPLUMBING/SiGN15PRINKLERlDEMOLITION <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 TO 4 PM <br />ADDRES/S: yy� PROPERNTAXH RMITB _ O C <br />l ST t'!/l�v��///� /I%��T St �! Z� � <br />�L for new wnstruction: Short PlaUsubdivision Lol No._ (altach copy of long legal descnption) <br />8� I Lic. <br />ILDiNU PERMIT APPLICATION CONrRaC7 PRICE oFwoRK w/i ✓�ri'-- <br />ing Use of Building /'✓�%' HEAT SOURCE: <br />oseJ Use of Building �/'iY Gas� Eiectric,_ C <br />�ing type: _ Single Family _ Dupl�sc_Townhouse _ Multi-Family �Commercial <br />�. of project: _ New _ Addition —� Remodel _ Repair __ T.L _ Sign _Sprinkler _Demolition_Change <br />riplion o( Work (adddional space pmvided on�fhe� /back): <br />�f:,J;'r99, C+/����//%/.'c'trJ 6cr/'".���I'! <br />�. you star�ed working withaut a permi[? `� YES <br />MECHANICAL PERMIT <br />ofProJect: _New_Addn � Alteralion_Repair <br />�(/'t:�<�/�%�/' O/' �r'i�/ %Jl�%�l% C�'cic�s�/� <br /><'.r/xatl-� �Y�J. <br />d <br />_NO <br />of Use <br />�;</ Jt <br />PLUMBING ?ERMIT APPL1GAr� <br />u(Pro�ect: _,New_Addn _Alleration_Repair <br />Show Num6cr (z) o/Oxtures <br />Medical Gas <br />Other: <br />I hereby certify thal I have read and eaam�aed this application and know the same lo be [ae and correcL All pwvisions oF laws and ordinances governing <br />Uiis rype of work �411 be complied with wnether speGfed herein or nol. The granting of a perm!t tloes not presume to give aulhority lo violate or cancel <br />lhe provision of any other state or local law regulating conslrudion or the pertormance of construction. That I am aulhorized by the o�mer of this propetty <br />to pedorm the wcrk�nvhich applicalion'• matle and I wmply with the Stale Conlraciors Law 7827 RCW and 296.?00 WAC <br />--__�s% �� ��i�/� �/ / Mcl,� �: POB 5y j <br />"'� ,�T /� Dnte RedMand� ����73 (Revised7/2011) <br />�OwneAAuthodzed Agent Sigwture � I <br />;��"��(�10.�i�/c� t�Gl\ <br />