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PERMIT APPLICATION <br />BUILDINGIMECHANICAL/PLUMBINGISIGN/SPRINKLER/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 FRON 8 AM TO 4 PM <br />ADDRESS: PROPEftNTAXq P� ���i I�U� /2 <br />`.1/ <br />1 z=� �-� o� r t�� � _ <br />Iar new cons�mc�ion: Short PlaVsu6division Lot No <br />ERJt�-ir�< Uu.>>�r�D <br />3�2� Nov �- �,Jr <br />C��r� <br />NG PERMIT QPPLICATION <br />6'isting Use of �uilding <br />_(altach copy ol long legal description) <br />Q7`�—��'�-i—�\(�b <br />Slate/Zip L� c�E1T �^-�\ `� � <U � <br />I Lic. # <br />Phonel[mail <br />VTACT FOR PERMIT <br />nclE-mail 1117 — °�'l O - �-04� <br />NTRACT PRICE OP WORK <br />HEATSOURCE: <br />Proposed Use of 8wlding _ � Gas__ ❑ear�c _ omcr__ <br />Buiiding type: _ Single Family _ Duplex _Townhouse _ Po7ulti-Family _ Commercial <br />Type of project: _ New _ Addition _ Remodel _ Repair _ T.I. _ Sign __Sprinkler _Demolition_Change of Use <br />Desc�ip�ion of Wo�k (add�lional space provided on fho back): <br />� L.�l`�l C�t C l L FU lZ-I�L' C_C �l-il�N ��c ���J 1G -1, c�i'.-li_ 4=th 1 <br />Have you started working without a permit7 _YES _NO <br />MECHLINICAL PERMIT APPLICATION <br />Typr ot Pro�ect: _New _Addn _Alteratton _Repair <br />ShowNumbcrla) ol/ixfu�es <br />SPRINKLERISUPPRES <br />o( Heads <br />PLUMBING PERN�lT APPLICATION <br />otProject: _Now_Addn _Alta�etlon_:topair <br />Show Number (q) o/ fixtures <br />i Toilet <br />Medical Gas <br />Other: <br />Other: <br />I hereUy ceitify Ihat I have read and esamined this applicalion and know lhe same lo be true and correct. All provisions ol laws and ordinances goveming <br />th�s lype ol work will be compLed with whether specifod herein or noL The granting of a pertnit does not presume to give authority lo vioiale or canccl <br />ihe vrovision of any other s�ate or local law regulating conSWction or Ihe pedormance ol consiruclion. lha� I am aulhonzed by IOe o��vner cl this pwpaty <br />lo pedorm th work for which applicalion is made and I c:mply with Ihe State Conlraclors Law 1827 RCW and 296.200 WAC <br />\ ._ � ,l�_, \ \ � I l' , l <br />�_, 1 - <br />OvhiadAulhorized Agent Signaluro Da1c lRecsetl2<0f iJ <br />