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PEaMIT APPLICATION <br />BUILDING/MECHANIGAL/PLUMBING/SIGN/SPRINKLERIDEMOLITIOf� <br />CITY OF EVERETT PERMIT SERVICES <br />3200 Cedar St., Everett, WA 98201 - 425-257-8810 — FAX 425-257-8857 — www.everettti•a.org <br />A�PLICATIONS ARF ACCEPTED FROM 8 AM TO 4 PM <br />.%SOS Lt�0�10.(c{ �k• <br />� <br />o�- o�e <br />lor new consimclion: ShoA PlaVsubdivision Lm n�._, (allach copy of long legal description) <br />,<'r�14 e��d 1=..n1,. ��r',F�,wi Phone/E-mail C'1Cf���il-LG�1110.1�.�0(YI �:I�i-9`SlG <br />�'.`�L"� �iO�I:UCt <br />.._.... �1A i���.mbl <br />r z�ro <br />L <br />LUfI Il'O.�Il, <br />BUILDING PERMIT APPLICATION <br />ly/SIz�MZiP [-i� fP_�Ij- � w /{ �'�,_�i <br />&ILic.# )f� r-U{� )•� C/. <br />Nhone/Eni3il yJ.S -� 71 -� � �l <br />Er�ii��.. �ntftvi <br />, �.. , cr.a - �c-�. � <br />PRICE OF WORK <br />Existing Use of Building � r. ��ir•r l h�a � HEAT SOURCE: <br />FroposedUseofBuilding 'a�-SicIC�Ih�:I _ Gas_ EledricT- Other <br />Building type: 1�. Single Family _ Du�lex _Townhouse _ MuL'i-Family _ Commercial <br />Type of project _ New _ Addition _ Remodel = Repair _-�.L _ Sign _Sprinkler _�Demolilion_Change of Use <br />Description o( Wo�k (adCrtional space provitledon the back/: <br />� /' <br />I1f�.>�G�CC W.t ci- 11)Cii!) ��,c.` ItU<i.Sc <br />kave you slarted working without a permit7 _YES v�NO <br />M�CHANICAL PERMIT AI'PLICATION <br />olProject _New_Addn _Alteration_Repair <br />- ai� handlinq uni�s <br />SPRINS(LER / SUPPRESSION <br />Number of Heads <br />PLUMBING PERMIT APPLICATION <br />of Projo.l: _Now_,Addn _Alleralion _Ropair <br />Show Nambcr!#) o//iz(ures <br />Medical Gas <br />Other. <br />I hereby cenily Ihat I hace read and examined this application and know Ihe same to be ime and .:orrecL All provisions ol laws and ordinances goveming <br />Ih�s iype oi work will be complietl wilh whether specifed herein or not. The granting of a permit does not presume to give authority to viola�e or cancel <br />the prevision of any other slate or local law re�ulaling construction or Ihe pertormance of constmction. 7hat I am authorized hy Ihe owner of Ihis pwpetly <br />lo perform Ihe �vork for �vhich aopliwtion is matle and I compiy �t�ith ihe State CoNrectors Law 1827 RCW and 296200 WAC <br />9/�y)aa�� <br />Owner/Authorized Agont Sl�jr.aturo Da�e (Revised 22011) <br />