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P�RMIT APPLICATfON <br />BUILDING/MECHANICALIPLUMBING/SIGN/SPRINKLERIDEMOLITION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 Cedar St., Everett, WA 982Q1 - 425-257-8810 — FAX 425-257-8857 — www•everettwa.org � <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM o�L `-7" � <br />��> PROPERTY TAX k P MIT N <br />ADDRESS: Q�� �����Sl. �/a tI �"`7 _ I S Z D D S OZ —D � <br />II M <br />far new construction: <br />290 ���Y�: <br />�'� �a� <br />D3 -��,chnolDoj��S <br />BUILDING PERMIT APPLICATION <br />Ezisling Usa of Building <br />Proposed Use of Buildir <br />No._ (atlach copy of long lega� description) <br />��� NZS-y53-45'�l5 <br />PRICE OF <br />. ,;a <br />�-�ISI- I ZZ <br />�il T�LSS�-�+� <br />- <07o Co <br />HEAT <br />iilding lype: _ Single Family _ Duplex _Townhouse _ Mulll•Family �C Commercial <br />�pe of projecL ,_ New _Addition _ Remodel _ Repair �[ T.L ,_ Sign ,_Sprinkler _�emolition_Change of Use <br />�Scriplion o( Work �add'Aional spaca pmvided on ttio back�: <br />Wi�nor iV1,bc.rior �,vno�(tion, vi.eui �v�+�r�or part,i-iohS � tamc.v dmrs, ��.0 rt.l�icS, <br />G i Vtew H GP rzSt�'oo vvi .�� II 6� Flo�r -lena.vi fi. <br />ave you staAed working wilhout a permil7 _YES �NO _ ____- <br />_Now_Addn _Alferallon,_Repair <br />_New_Addn _Alferalion_Repair <br />Medical Gas <br />Other: <br />I hereby ceAi(y that I have read antl examined this application and know Ihe samo lo he true and correct. NI provieions of laws anA ordinances goveming <br />Ihis type of work will be complied vrith whether specifed herein or not. ?rs yranti�g o( a psrmit does not presume lo give authonty to violate or cancel <br />the provision ol any olher state er local law re9ulalinq construclion or tne pedormance of construction. That I am aulhorized by the owner of this property <br />lo pe Iha wnrk fo ich appli lion is made �nd I camply �Nlh the State C traclors Law 1827 RCW and 296.200 WAC <br />�/��/��� �y JZ <br />� '"�`�'^�`�" — / G� e (Revised7i2077) <br />nar ulhodzed Age � lSlgna e I/ <br />� <br />