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� <br />PERMIT APPLICATION <br />CiUILDINGIMECHANICALIPLUMBINGISIGN/SPRINKLERIDEMOLITION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 Cedar St., Everett, WA 98201 - 425-257-8810 — FAX 425-257-8857 — www.everettwa.o/ryg <br />APPLICATIONS ARE ACCEPTED FROM 8 P.M TO 4 PM 1""7 `� Z <br />ADDRESS: � 2I /L�� ./i.. . PRCIPERlY7AXq PB I I�I —OO <br />/ �O �t �/�•�/ <br />for new conslmction: Short PlaUsubdivision Lot No._ (atlach copy of long legal descriplion) <br />. �.. . �. e �.i.. PhonelE-mail % �) W ' i 7 `Y — �Y V1'i b <br />�� <br />LD14G PERMIT APPLICATION <br />Use of Building <br />Stat �e/Zip � �/�� ��' �O � <br />I Lic. # <br />Phone/Email <br />VTACT FOF PCRMIT <br />nelE-mail ��4 ��U C7�( <br />NTRACT PRICE OF WORK �Q ( <br />HEAT SOURCE: <br />�sed Use of Building � " — - - — <br />ng type: _ Single Family _ Duplex _Townhouse _ Mulli•Family _ Commzrcial <br />of project: _ New _Addition _ Remodel _ Repair_T.I. _, Sign _Sprinkler_Demolition_Change of Use <br />riplion of Work (addifional spaceprovidedon th��): � � Q � ��� ! � /' <br />�3w� l�! ��/�v �� y u l v�.y ���a6��L (RiuR.C� <br />�f ��t� <br />you started working without a perm(l7 _YES �NO <br />MECHANICAI. PERMIT APPLICA710N <br />of ProJoct: _Nnw_Addn _Alteretion _Ropair <br />/ SIJPPRESSION SYSTEM <br />Number of <br />PLUMBING PERMI7' APPLICATION <br />oiProJect: _Now_Addn _Alloration_Rupair <br />ShowNumberlM) of/7xtares <br />Medical Gas <br />Olher: <br />I hereby certify Ihat I have reaJ ani examined this application and know lhe same l0 6e lrue a W wrrecl. All provisions ot laws and ordinances goveming <br />this type of work will he complied Nith whether specifed herein or not. The granling of a permi� does not presume to give authonty to violate or cancel <br />the provision ot any other stale or local law regulating consimclion or Ihe pedormance of consWction. That I am authorized by the owner of this property <br />to pedorm thp vork for which applicalion is made and I comply with Ihe State Confraclors Law 7827 RCW and 296.200 WAC <br />< ,il, /� �_q�/Z <br />� [i/<zf� � <br />OwnorlAuthorized Agont Signaturo Date (Revised?/2077) <br />� <br />