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From <br />041l,�/2012 09:47 #319 P.0021002 <br />� t�j�S��7 % <br />PERMIT APPLICATION <br />BUILGiNG/MECHANICALIPLUMBING/SIGtV/SPRINKLERIDEMOLITION <br />CITY OF EVERETT PERMIT SEP2VICES <br />3200 Cedar St., Everett, WA 98201 - 425-257-8610 — FAX 425-257-8857 — <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />IOrnewcon6Wction: StwhPlaV5u0tlivislon Lot <br />UILDING PERMIT APPLICATION <br />use ot <br />� <br />&ILic.# <br />_ (alta:h copy ol 1on91egal dosuiPtlon) <br />� S-3 �� — �l 1088 <br />Eve�lc=Z-1- b�1 � �I� 2G 8 - — <br />�-e, I�c �FAS�"WWN�i S C <br />P�one�Emeil �,�Up '� <br />�S��r �}2S(a3(v•7ag <br />Ti,.� � e GCa) -�'1t �'W a-}e ('ltie a� . C�'1 <br />PRICE OF WORK <br />'wposed Use �Of(Building I �.os�p nncmc vmw_ <br />�uliding type: /� Singla Family _ Duplex_ Townhouse _ MWtl-Famiiy _ Commercial <br />ype of projacl: _ New _ Addition _ Remotlel � Ropair _ T.1. _ Sign _Sprinkler _Demolition_Chenge of Use <br />�esuiption of Work /etlenlonal spoco pmvltlod on tne eack) : <br />� r�(Y1 t�re I re�\ ClC �. � CA S l� ct-�e-� � CL`�-'� � <br />lave you slartod working without a permltl _YES _NO <br />MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATIO <br />ofProjecl: _Naw_Addn <br />offlx[ures <br />/ SUPPRESSION <br />of ProJect: _New _Atltln _AltweUon _R¢palr <br />S�owNumbcrlll olll+turas <br />Medical Gas <br />Olhor: <br />I hareby ceNfy thel I �avo read antl examinotl lhis appliwtian entl kn�w the same to be We an0 coneU. NI pmvisians of laws and orElnancea gaverniny <br />lhls rype of vrotic will be wmpliad with v�iothar specified hamin or noL T�e grantin8 of a permll tices nol pmsume lo giva authoriry lo vlolate or wncel <br />�he provlsion ol eny other stato or local law �egulelinp consWCGon or Ihe peAormance ol constructbn. Thel I am autMrizetl hy Ihe owner of Ihis property <br />lo parloml tne work Ior wfiich appllwtion Is mada antl I compry with lha State Contraporo Law 78.27 RCW aM 2P6300 WAC <br />nodAuthorized� t gnalure � � ��a�e (ROWSad?/t011) <br />