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T <br />� <br />PERMIT APPLICATION <br />BUILDING/MECHANICALIPLUMBING/SIGN/SPRiNKLERIDEMOLITION <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 <br />���Q. <br />br new constructiort Shotl PlaUsubdrvision_ <br />2�QQ�� �a�i$H <br />BUILDING PERMIT APPLIGATION <br />Use of Building t"itMl <br />d Use of Building k' <br />�TAX# I P�'Tl�a <br />� � � <br />rt No._ (attach copy ot long legal tlescnphon) <br />iail UZ�j.74�rJ �Z� e(riNQ.rijy � <br />Z�D Gli�. �� I l�%' �i'"iC C.L+6 <br /># <br />PhonelEmail <br />T FOR PERMIT <br />iail <br />:T PRICE OF WORK <br />ngtype: ✓S�ngleFamily _�uplex_Townhouse _Multi-Family _Commercial <br />of project: _ New _Addition _ Remodel _ Repair �T.i. _ Sign _Sprinkler _Demolition_Change of Use <br />�iplion of W o�k (addrtional space providetl on Ihe backJ : <br />Have you started working without a permit? _YES `� NO <br />MECHANICAL PERMIT APPLICATION <br />of Project: _New_Atldn _Altefation <br />Sfrow Number (N) o!/ixtwes <br />AIC — air handling w <br />�� Forced air svstems <br />Heat pump <br />Unit heater <br />tz�p�a� u��-c�a -u�e C��� <br />PLUMBING PERNi1T APPLICATION <br />eofProject _New_Adtln _Alleration_Repalr <br />Shaw Numoer (lt) oi fixfures <br />Toilet <br />I Balhtub <br />Lavatory (wash basin) <br />� Shower <br />' Kitchen sink & disposal <br />� Dishwasher <br />. � Cinthes washer <br />Medical Gas <br />Other. <br />I here�y certi( that I have reatl antl eaaminea this applicsuon and k�ow Ihe same In be �rue and correct. AII pmvisions of IaHs �ntl orainances govemmg <br />Ihis typ v.ork be complied vnih Hliether specdie,l herein or not. The g�anbng ol a pertnit does not presume to grve aulhonry to violate or cancel <br />Ihe pr ision of any Iher state or loca' law regula�ini wnsimction or Ih= peAormance ol constmttion. Thal 1 am authonnea by ;he c�sner d Vns Omceny <br />to peAorm 1� work 1 r which app�icalion is matle a��d I comply vath Ihe SLate Contraclors Law 18 27 RCW antl 295200 WAC <br />���,V « <br />Ownerinuthorizetl Agent Signaturc Date iRewsetl2i207 t; <br />