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( <br />wERMIT APPLICATION <br />BUiLDING/MECHANICAL/PLl1MF3iNG/SIGN/SPRINKLER/DEMOLITION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 Cedar St., Evereri, WA 98201 - 425-257-8810 — FAX 425-257-8857 —wv�vo.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM I" o� S Z <br />AD RES : PROPERiYT N PERMIT/ <br />��s-� /I%a,�r�vra�, �/U� �os'�` 0000 cl Z r, <br />� <br />,L tor new rnnsWction: Short PlatlsubdviWon Lot No._ (attach ocpy of lonp lepai description) <br />BUILDING PERMIT APPLICATION <br />Use a <br />d Use <br />pRICE OF WORK � 31 L� `d <br />SOURCE: <br />ng type:� Sin81e Family _, Duplez _Towr'iouse _ Multl-Femily _ Commerdel <br />of pro}e New Addition _ Remodel Repair _ T.i. _ Sign _Sprinkler _De 1' on_Change of Use <br />'iptiono(Wofk�edditioneltpeceprovidedon 6e6ack):��.�/�� d�✓/���'j�/�/ (/4'r'Qr <br />��X,i ,>-, c�,, i �jj� a • - s <br />�vr�r, fi�}� �- � , < < <br />you sWrted worlcing without v permk7 ._YES � NO <br />___�.. _....... ..�n.a.� wee� u�er�f1M PLUMBING PERMIT APPLICATION <br />ofProJeet _New_AdM _IUtetatlm_Repalr <br />_New_J1dan _aDeratlon_RePnlr <br />Medcal Gas <br />Otlier: <br />I hereby ceby that I have read and examined this appiicalim and Imow the same a be We and carat A9 prwisions of lews and or�inances govemin8 <br />lliis rype of workvnll be complied with whether spe�ed herein or nat The granUnp of a permit daes nM presume to pvo auMorily ta violete or cancN <br />the provision of eny other state w local law regulatln8 ��nstrucCon or the peAormence of construction. T�at I am authorized by Ifie oxner of this property <br />to pedorm the vrorklor h application is mede and I comply vrith the State Contradore law 18.27 RCW �+d 296200 WAC <br />.'�-r��'��/%n',..��„�� �/ /6 /2 <br />Ovrt�er/AuMoNxed Apmt StpnaNre Date (ReKsed 7/X1: fI <br />i�� <br />