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PERMIT APPLICATION <br />BUILDING/MECHANICALIPLUMBINGISIGNISPRINKLER/DEMOLITION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 Cedar St., Everett, WA 98201 - 425-257-8810 — FAX 425-257-8857 — vdww.everetlwa.org <br />APPLICA710N5 ARE ACC[PTED FROM 8 AM TO 4 PM <br />PNOPERTYTA%p P MIT# <br />ADDRESS: � 2�J j -CiD <br />�+C-i.- (�.._.' � �.� c/SfJL 1 - <br />lor �ewcons!r�tlion: Short PlaVsubdivis!on <br />h <br />PERMIT APPLICATION <br />Usc of 6uilding <br />Lot No._ (altauh copy cl long legal tlesuiptlon) <br />��e.mai� yL%3T"5-tf7/6 <br />late/Zip 6i �el� w� p�z' <br />Lic. # <br />Phone/Email <br />TACT FOR PERMIT <br />a���_ ���t�� � <br />eie�mon 4 Z S 3 S'1 - y� I�. <br />TRACT PRICE OF WORK <br />HEATSOURCF.: <br />osed Use oi Building � — - — <br />inglype: �SingleFamily _Ouplex_Townhouse _Multi-Family _Commercial <br />ol project: _ New _Addition _ Remodei _ Repair _ T.I. _ Sign _Sprinkler �Demolition,_Changr. of Use <br />riplion o( Work (addilional space provided on fhe bacA) : �I ��� � `�� <br />�-'„ti �am..��,� <br />� you starled working without a permit7 _YES �/NO <br />MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br />o1ProJecl: _New_ 4Adn _N�eralion_Repalr <br />ION <br />ol PrqeU: _New _Atldn _Alteratlon _Rcpair <br />Shnw Num6er /pl ol fltlu�Cs <br />Unnal <br />Medical Gas <br />Olher: <br />I hereby ceddy Ihat 1 have read and e�amined Uiis applicalion and know Ihe same to be Ime and wrrecl. All provisions ol laws a�tl ortlinances goveming <br />this tVPe ol work w•ill be wmplied wilh wi�ether specifie6 hemin or noL T�e g�anting of a permit does not presume to give authorily to violate or cancel <br />the pmvision af any otPer state or local law regulaiing e.onstmclicn or Ihe peAormanco ol consiruction. That I am authorized by Ih5 exner ol ihis property <br />to pedorm the �5ro�k for v:hich application is made anG I comply wilh ihe Slate Contractors Law 1927 RCW and 288200 WAC <br />�� 7 j J�> <br />� /�� �,'4��Z <br />Own` cr�4( iorized Agenl5lgnaWre Oate (Revised 24077) <br />