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� <br />PERMIT APPLICATION <br />BUILDINGIMECHANICALIPLUMBINGISIGNISPRINKLER/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 8 AM TO 4 PM 7`�� `� <br />(U�� 5� �1�F���1 <br />for new construction: Short <br />�v, <br />Lot No._ (attach cop <br />PhonelE-mail �O(o ��z <br />:, i�1 � 2 N� I i., !J C IcnYi: <br />R I) NO'1'i����RDEn IL&I <br />rd Cc�s S � e Co hsfi rc�t �f� � <br />INE S NAMEf Z�,� <br />I'�I%F :7 �L'�I��i7 <br />of long legal description) <br />Wr�. <br />J <br />BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK � <br />Existing Use of Building �y%�/�IL S i u'(_G HEAT SOURCE: <br />ProposedUseoBuilding ��'F�/�l�- �T'vF��L Gas� Electric_ Other_ <br />Building lype: _ Single Family _ Duplez _Townhouse _ Multi-Family i� Commercial <br />Type of project: _ New _ Addition _ Remodel _ Repair _ T.I. �, Sign _Sprinkler _Demolition_Change of Use �v <br />Descripliono(Work(additionalspaceprovidedonfhobackJ: �L'GI�' �"Z(;�ZW' <br />Jal �e <br />Have you started working wilhout a permil9 _,YES �NO <br />MECHANICAL PERMIT APPLICATION <br />ofProjncL• _New_Addn �AitereHon_Repair <br />Shnw Number /pl of lxmres <br />Number af <br />PLUMBING <br />of Project: _New_Addn <br />Medical Gas <br />Other: <br />_Repalr <br />I hereby certi(y thal I have read and examined this applicalion and know the same to he We and correct. All provisions of laws and ordinances �overning <br />this type of wnrk witl be complied wilh whether specified here�n or no4 The granting of a permit does not presume Io give authority lo violate or cancel <br />the pmvision of any olher state or local law regulaling conswclion or Ihe peAormance of constmction. That I am aulhorized by the oHner o! this propeny <br />to pedo m�e �wrk fo ch application is made and I comply with Ihe State Contraclors Law 1827 RCW and 29G200 WAC <br />i <br />�����: � ��,,,��— �/,/.,_ <br />Ow edAuthorized Agenl Signature � Dale (Revised712077) �/z <br />