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(� <br />PERMIT APPLICATION <br />BUILDINGIMECHANICAUPLItMBING/SIGN/SPRINKLER/DEMOLITION <br />CITY OF EVERETT PERMIT SERVICES �.0 4`.1/ <br />3200 Cedar St., Everett, WA 98201 - 425-257-8810 — FAX 425-257-8857 — wuvw.everetlwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />tor new constructlon: Short <br />PERMIT APPLICATION <br />Use of Buitding <br />Use oi Building <br />No._ (attech copy ol long <br />PRICE OF WORK <br />HEAT SOURCE: <br />�oZ <br />ng type: _ Single Family _ Duplex _Townhouse _ Multi•Family _ Commercial ��I,,,ttt <br />of proJect: � New _ Addition _ Remodel _ Repair _ T.1. _ Sign _Sprinkler �,uemotitlon_Change of Use <br />� <br />iption Of Work (eddifional space provided on fhe back): ���� <br />j I �, <br />jl�'�.Yj'Y'�� 15J'1 �/G11 LO'C15'Tr/ <br />you atarted working wllhout a permit7 _YES _NO <br />MECHANICAL <br />ofProJecl: _Naw_Addn _Altention_Rep�ir <br />Show Number !M) 01 /iutures <br />PERMIT APPLI ATION <br />ofProJeet: _New_Addn _Ak�ntlon_R�palr <br />Other <br />I hereby ceniry Ihat I have read and examined this appiicatlon and know the same to he tnie and correct. All provisions of laws entl ordinences qoveminp <br />this type of work will be complied with whether sped8ed herein or not. The granling ol a permit does not presume to give authority lo violate or cancel <br />Ihe pmvision ol any olher sta)� or Iawl law r�ul in3 conslmction or tha peAortnance of wnstrudion. That I am authodzed Dy t�e owner of this property <br />lo perform Ihe�w�Qr whi (� pplication i ad nd I comply with the S'ate Contractow Law 7827 RCW end 298200 WAC <br />r . �- 5�-� <br />wnarlAuthorizad A nt Sian� re Dale (Revised 1?/2010) <br />