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� <br />PERMIi APPLICATION <br />BUILDINGIMECHANICALIPLUMBINGISIGNISPftINKLERIDEMOLITION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 Cedar St., Everett, WA 98201 - 425-257-8810 — FAX 425-257-8857 — ww <br />� APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />)DRESS: PROPERN TAII t <br />�Lf...n�.e-11-rnR.�� �'�,�,� oi.8D514SLb�rJ���ODD11 <br />fpr nBw construdion: ShINt PlaVsubAivision Lot No._ (ettech copy of b� <br />BUILDING PERMIT APPLICATION <br />811.iC.# 1 <br />C Phone/Em�� <br />O ACT FOR PERMI <br />�onelEmail , �L�iGL� • <br />ONTRACT PRICE OF <br />UseolBuilding ('r►I�UWCY' � <br />d Use of Building C.l.i� ��7�" <br />IJ�Ti <br />ll <br />Cescriptlon) <br />c. com <br />Building type: _ Single Famiiy _ �uplex _Townhouse _ Mutti-Famlly � Commercial <br />iype of prajed: _ New __ AddRion _ Remodel _ Repair�T.l. _ Sign _Sprinkler _Demolkion_Change of Use <br />Descrip!ion ot Work (ad�dit�ion.1a-�aoece provlded on tna oack): '{�p,p�q,Cq, Wf(5}?� `J61JCv' CA%�1M1l.'`, ci CX.��'b�"� <br />ippt�}lY�; (�pl}pi«c-t. 011.'Ci4�O�i � �pE'+tp�J. <br />- o <br />you at�rted working without a permlt7 _YES 1N0 <br />PfoJacl:�New_Adtlo _Alterffiion_Repalr <br />_New_AOAn _AnersUon_Rapelr <br />Other: <br />I hereDy certify lhat I have reaC arM examined lhis eppliratlon aM know ihe same to be We end cortect. All pmviabns of laws antl oNinances gaveminp <br />this rype of work will be comWictl w+1h whether specified herein w nat. The pranUng of e pem�it Eoas not presume to plve auNoriry to vblate w cencel <br />the provislon of any other stale or Ixal law reguleGng construdion or t�e performance of wnsiruction. Thet I em authonzed by the amer ot this property <br />to peRartn the wod for which application is mede an� I comply with ihe State Contrectors Law 18.27 RCW atM 298200 WAC <br />� <br />OwnerlAut o Agant3lgoet�re Date (Rev'aed7R011) <br />�2 <br />