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PERItIIIT APPLICATION <br />BUILDINGIMECHANICALIPLUMBINGISIGNISPRiNKLER/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 8 AM TO 4 PM � <br />nnnRFRS• PftOPEkNTAXN �MIL� � �� �� �, <br />[0 9-o No %T AvE <br />for new conslmction' Short PlaVsubtlivision Lot No._ (attach copy ot long legal description) <br />� �.._....�.. .nn.,. Phone/E-mail �ZO��q3�—SZ�S _ <br />2255 �o' Ave <br />ACTOR �i�r � (�. <br />SAR3 /S-1� F <br />BUILDIPIG PERMIT APPLICQTION <br />i�!�c�r� <br />. <br />PRICE OF WORK <br />Existing Use of Building Sn1[,G6��dM�GY HEAT SOUkCE�. <br />ProposedUseoBuilding <i i�' �<aMuY Gas._ electric� Olher_ <br />Building type: ✓ Single Family _ Duplex _Townhouse _ Multi-Family _ Commercial <br />Type of pmject: _ New _ Addilion � Remodel _ Repair _ T.I. _ Sign _Sprinkler _Demolition_Change o( Use <br />Descriptiono(Work(additionalspaczprovidedonfheback):ADDIn/G �BATARooM W'BASFJ�'iF�T. ADDI�lG SoMB L!(�rlTs <br />q�n Fix�NG OQYw��-L ��Ar��T. �ATwC, GARPEF �T��E. <br />/ <br />you slarted working without a pennit? _YES V NO <br />MECHANICAL PERNi1T APPLICATION <br />of ProJect: _Now_Addn _Allaratlon_Ropalr <br />SPRIFIKLER I SUPPRESSIOt�S <br />NumberofHeads <br />PLUMBING PERMIT APPLICATQON <br />of Project: _Now�[Addn _Alloratlon _Repalr <br />Show Numbcr (q) ollixtares _ <br />sink <br />Medical Gas <br />Other. <br />Giher: <br />I herehy ceAify that I have read and examined this appLcaiion and know �he same lo be tme and correct. All provisions of law, and oMinances goveming <br />this rype ol v��ork will be complied wifh whelher specifed herein or no1. Tho c�ranting of a permit Ooes not presume to give authority tc vlolate or cancel <br />the provision ol any other stale or local law re9Walin9 Conslrucliun or Ihe periormance of conslmction. Thal 1 am authorized by the cvmer of this property <br />to pertonn Ihe woik lor which applicallon is made and I comply v:ilh Il�,e State Conlraclors 1.aw 1027 RCW and 236200 WAC <br />�. ��p�..__ O �1�� <br />OwnedAuthorized gent Signaluro �fe (Rcvised 220171 � <br />Z <br />