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PERMIT APPLICATION <br />BUILDINGIMECHANICAL/PLUMBING151GNISPRINKLER/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 6 AM TO 4 PM <br />ADDRESS: PROPER7YTAXU PERMIT# <br />-- -� ..,_._, �_� �.rfli � za��,��oo3or�a-oo � <br />lornewcanslmction: ShortPlaUsubdivision_ <br />� <br />,..,.... --""--- � -- ---- <br />/kdva.riCec�l "r�a f{'iC <br />UILDING PERMIT APPLICATION <br />Use of Building <br />Lot No.__ (atlach copy ol long legal description) <br />C. PhonelE-mail ob-6 - f d <br />City/StatelZip �� t� �'C�F� V"J%� U 3� <br />( L&ILic.# .CMr- C - <br />'� WA ���Ofj2 Phone/Email �}-a, �`ba) 3��'% <br />CONTACT FOR PERMR <br />PhonelE�mail <br />CONTRACT PRICE OF WORK��IU��i-' 7S � O U <br />HEAT SOURCE: <br />... . ✓ nma. <br />Proposed Use of Builtling - � —� <br />Buildinglype: _SingleFamily _Duplez_Tovmhouse _Multi-Family ✓-Commercial <br />Type of project: _ New _ Addilion _ Remodel ✓ Repair _ T.I. _ Sign _Sprinkler _Demolition_Change of Use <br />DeSCripliOnofWOfk(addilionalspaceprovidedonfhebackl� _ � � ���,}- p(�yy�� <br />F�emove a�nEl ihSiull � s-lo�� rr�� -l-oP y��t��9 <br />v�tii.-V- �`,ICe fcc� k,�K2 oa� e�c.�s•i-i,�-o� p.e.n����.hon � <br />Have you slarted workfng without a permfl9 _YES � NO <br />NIECHANICAL PE RMIT APPLICATION <br />of Prolect: _New_Addn _Alteralion ✓ Repair <br />SPRINKLER I <br />PLUMBING PERMIT APPLICATION <br />ofProJect: _New_Addn _Alteralion_Repair <br />heater <br />Medical Gas <br />Olher. <br />I here6y cetlify that I have read and examined lhis application antl know 1he same to he tme and cortecL All pmvisions of laws and ordinanws goveming <br />this type ol vrork will be complied vnih whether specified herein or noL The granling of a permit daes not presume to give authority Io violate or cancel <br />Ihe provislon ol any other slate or local law regulaling conslmction or Ihe pedormance of constmclion. That I am authorized by Ihe owner ol this propeey <br />to pedorm Ihe work 1� i�P liwtion is made and I comply with Ihe Stale Contractors Law 18.27 RCW and 296100 WAC <br />� �d��a � � ) <br />OwnerlAuthoNzed Agent SignaWre <br />Da1e (Revlsed 2/207 7) <br />/� <br />