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� <br />;� <br />PERMIT APPLICATION <br />BUILDINGI�JIECHANICALlPLUMBINGISIGN/SPRIN KLER/d�M%LITION <br />Cli"Y OF EVERETT PERMIT SERVICES �� ` <br />3200 Cedar St., Everett, WA 98201 - 425-257-8810 — FAX 425-257-8857 — www.everettwa.org / <br />APPUCATIONS ARE ACCEPTED FROM 8 AM TO 4 PM �� <br />. rnecorrrnrn PERMITp/1 ii�� <br />lorriewconstruclion�. Shorl <br />BUILDING PERMIT APPL![_'aT10N <br />Use cf Building <br />(attach copy ol lon.� les;al aescnption) <br />& I Lic. # LL � <br />� PMne/Email <br />NTACT FOR PERMIT-t—� <br />ione!E-mail �� Zo �+ <br />ONTRACT PRICE OF WORK <br />�'q l�.t.,l(�}+-�/P�� 5� <br />i/D� z�� <br />�� <br />Proposed Use ol6uilding '� — � �" "` �— ��� �— <br />Building type'. _ Single Family _ Duplex __Townhouse �Multi-Family _ Commercial <br />Type of pmject: � New _Addition _ Remodel �Repair,_ T.I. rSign _/�Sp�r�in�kler _Demolition_Changav��f User Z <br />�escription oM'Ork (adddional space pmvidetl on the back): ,/ T1s�G Ni7�.� I'��S '��� ���� <br />�14.4CA um�o 1=��n.5 inJ (gi�.4�y �h� N41�6L�u.�c56(�i t�5�+�^wi ��aE� <br />CFau�44 !s'fPS�Jc� <br />Have you started working without a permil7 _YES ,�NO <br />MECHIbNICAL PERMIT APPLICATION PLUFA[i1NG PERMIT APPLICATION <br />ofPro�ect: _New_Atldn _Alteratlon_Repair <br />Show Number (M) ol flxtures <br />i A/C-airhandlinqunits <br />ProJecC _New _Addn _Alteratlon _Repalr <br />Medical Gas <br />Ol�ier: <br />Other. <br />I here�y certdy ihal I have read and examineC Ihis applc;ation and know Ihe same to be truc and correcl. All provisions cl laxs an<I oNinanccs gonemmq <br />this rype ol work will be complied x+�h whether sFeciee�! tverein or noi. The g��ting ol a pe-vil dces nol presume to grve a�th,only to violale or carcel <br />Ihe p�ovisi:�n of any olher 6tate or loral law regulat�ng consiruction or I�e pedormance ol ccrosWdlort That I am a�:honzed Cy the owner ol Ifiis pr�pe�y <br />to o�form ihe v.or}'(oi y.hiyh applica6on is matlu zntl I comply wilh Ihe State Cont2ctor5 L3w 1B 27 RCN' antl 296200 NlAC <br />� RemSed 220tt) <br />