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PERMIT APPLICATION <br />BUILDINGIMECHANICALIPLUMBINGISIGNISPRINKLERIDEMOLITION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 Ceda� SL, Everett. WA 98201 - 425-257-8810 — FAX 425-257-8b57 — ww� everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM uZ � 7— � <br />PROPERTITAXN PERMITN <br />.....nocc. _ _ ' _ n q / _J./� -� _ / <br />fornewwnstmction� Short <br />BUILDING PERMIT APPLICATION <br />Use of Building <br />No _(���ach copy of 1on91egal descripuon) <br />M <br />u <br />�ew.� L'�rt,�wt^ <br />_ �,��� 3 G, c• 7`i'�l <br />RACT PRICE OF WORK _ <br />HEAT <br />� <br />Proposed Use ofpuilding - <br />� <br />Building rype' �Single Family _ Duplex _Townhouse _ Mulli-Family _ Commercia <br />'ype of project: _ New _ Addition _ Remodel %Repair _ T.I. _ Sign _Sprinkler _Demolition_Change ol Use <br />DescriptionofWork(atltlroonaispac �ov�dedenthebacNi: I1� S � �,_� �,ypµ�� <br />� �.. � v�o�.z .` v. t.rn v� I N c r t^� <br />�{-t')�aK�.., l.`ti'Z_ �-+1 �=-,r�-<.-S . r� CY-cu�..�' <br />Q.t-�) I�_ L. L,i,ti-; �, '..:.:.� <br />Have you started workinc� without a permit7 _YES �NO <br />MECHANICAL PERMIT APPLICATION <br />pe ot Projecl: _New_AAdn Aiteralion <br />Show Nimrber (IX) ol Iixwres <br />i e�r _ :,tr handlma ur <br />15 <br />I BOd2f � <br />Refnqeration <br />� Wootlstove <br />� Ductinq <br />I OO�er <br />SPRINKLER I SUPPRESSION <br />� Number of Heatls <br />�J (� �d%•y, <br />c c�.� <br />PLUNiBING PERMIT APPLICATION <br />ofProjecF. _New_AAdn _A��eralion_Repair <br />snnwNumberlbl ollirtures <br />ij}� <br />Medical Gas <br />Other <br />�. ��ere;;y cernh� Ihat I have read antl exammetl �hi5 applicaticn and kno:v U�e san��e to be irue antl [orrecl NI DroviSions o� lav5 sntl utl.��a�'.,.54o�•on��� <br />���. s rype ot �cc�k v.iu be comDhetl enth wheiher speufred herem or net L�,e gr�nur.9 0l a pennd does not presume lo grve authen;y �o .. !�. or ca�cel <br />�r�e provision of a�y otner state or local law re9utating co�strucUon or the pedormance ot construction That I am aulhonzed tri tre cv.ner of this preFe«I <br />�.o peAorm tne v.ork tor which application is made and I comply �ti�th the State Contraclors Law 70 27 RCW and 296 200 WAC <br />I �� L� <br />��/..1�-'�' iil(M, t.� .i r� l'� <br />1)... !�'�=wsed'✓201 U <br />O�.vnerlAuthorimd Agont Signaluro <br />