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s <br />: <br />PERMIT APPL9CATIqN <br />BUILDINGIMECHANICAL/PLUMBINGISIGN/SPRINKLER/DEMOLI710N <br />CITY OF EVERETT PERMIT SERVICES <br />3200 Cedar Sf., Everett, WA 98201 - 425-257-Sf310 — FAX 425-257-8857 — v�nv���.everettwa.org <br />APPLICATIONS ARE ACCEPTEO FROM 6 AM TO 4 PM _ <br />ADDRE55: <br />3� ,�c No�iT Av+c <br />TA% q <br />ter new conslmction: Short FlaUsubdivision _Lol No._ (attach eopy ol long b.�gal descripiion) <br />� <br />S; F Ccr/s'r2uLT� <br />!�`1�PL S� O/.�G <br />ILDING PERMIT APPLICI►TION <br />Existing Use cf Bwlding <br />FhonelE�mail �,20 <br />City(Slale2ip /1Q i�Pl <br />L&ILic.# <br />3i-S:�-.2� <br />sr_A�P, !<�A• <br />IPhonclEmail �;Zp(� <br />�RPERMIT S�,�ql <br />�o20'•n% �. <br />PRiCE OF WORK _ <br />�i .. Sz <br />J�/ F:q�{rN <br />3�_s�zs <br />HEATSOURC <br />Pmposed Use of Buildina_ � -- - - - — <br />Suilding lype: _ Single Family _ Duplex _Townhouse _ Multi-Family _ Commercial <br />Type o( project: _ New _ Addition _ Remodel _ Repair _ T.I. _ Sign _Sprinkler _Demolilion_Change of Use <br />Descrip�iono(Wo�k(addihonalspacoprovidedonlhebackJ: j���L17/p�,/ Or (lyT(,�IU �qnA�„�_$ (r� TFih- <br />aFlG(= UF TNe NOU3� <br />� you starter! working withou[ a permit? _YES �NO <br />MECHANi.CAL PERMIT APPLICATION <br />o1PmJect: _Now_Atldn _Altcration_Repalr <br />Show Num6cr (N) o/Iix:ures <br />i AiC - air handlina unils <br />� Otlier__ _ <br />I - <br />SPP.INKLER I SUPARESSIOk SYSTEM <br />PLUMBING PERMIT APPLICATION <br />ofProJocU _New_Addn _Alloratlmi_Ropa�r <br />Show Numbcrlql ol /ixfures <br />Medical Gas <br />Olher: <br />LI NumberofHeads II � """'. -_- _ <br />I hemby ceil�ly Ihat I have read and examined this appliwtion si�d kno�v Ihe same to Ue true and correcL All provisions of laws and orCinances goveming <br />this typc of �mrk will be wmplied wi�h �vhether specifed herein or noL 7he c�ranlinc� o� a permil does not presume w give autY,cnty to vida!e or cancel <br />Ihe provision of any other state or local law regulaling construction or Ihe pedortnance ot conshuction. 7hat I am , ulhonzed 6y the �vrner o( ihis Rroperty <br />Io pedorm Ihe work for �rhich applicalion is matle and I comply with ihe Stale Conlradors La�v 7827 RCW and 296.200 VJAC <br />Ow�..�.L�.� �'. �� �7 j /i�J�I�I <br />uthorizoA A96nt Slgnaturo � ' ���� (F.'evised ✓2011J <br />