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(� <br />PERMIT APPLICATION <br />BUILDING/MECH,4NICAL/PLUMBING/SIGN/SPRINK�ER/DEMOLITION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 Cedar St., Everett, WA 98201 - 425-257-8810 — FAX 425-257-8657 — www.everettwa.org <br />APPLICATiONS ARE ACCEPTED FROM 8 AM TO 4 PM �p f Z <br />ADDRE55: PROPERTV TAX p �, `R <br />/nn� ufi S.t_rri�liN.�s/ .:�:�. Z�lnSli[7A7�-n'(l��.M�� V����l5'�' <br />tor new wnsiruction: Short PlaVsubdivision Lot No._ <br />BUI�DING <br />Use of Building <br />�.d Use ot Buiidir <br />APPLICATION <br />& I Lic. # <br />h copy of long legal description) <br />�-�. �,�✓i-- 9 �'7. <br />,�y���� <br />�fzs� 7(ps-�3s- <br />f�Z-1"V1tU-Gr S�, <br />yzs��c�.�s� <br />� . .. w....� <br />PRICE OF WORK <br />SOURCE: <br />ng lype: _ Single Family _ Duplex __Townhouse _ Mulli-Family �Commercial � <br />of project: _ New _ Addition _ Remodel _ Repair _ T.I. �'�Sign _Sprinkler _Demolilion_Change of Use <br />rip�ion of Wofk (addifional space provided on the backJ: �,`��c�p �/J � �(,� ��� <br />v n J� i�.�� 9 <br />J <br />you sta�ted working wilhout a permil? _YES � NO <br />ot <br />SPRINKLER <br />PERMIT <br />_Alteratlon _Repair <br />PLUMBING <br />ot ProJect: _New _Addn _Alteration _Repalr <br />Show Num6er f#1 0l flxfures <br />Medical Gas <br />Olher. <br />I hereby certify lhat I have read and examined lhis application and know the same to be lruA and wnect. All provisions of laws and ordinanr.es goveming <br />this type �f work will be complied with whether specified harein or not. The granting of a pertnit does not presume to give aulhorily to violala or cancel <br />the provision of any othei state or lowl law regulating constructian or the peAormance of consWcuon. That 1 am authorizsd by tha ovmer of fhis property <br />to peAarm the work for which application is made and I comply wilh the State Contractors Law 1827 RCW and 296.200 WAC <br />�� �� <br />w r/AuthoPlx dAgentSignature Date (Revised7/20ffJ <br />/L <br />