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� �-� ��c �Q � � O 6' �` � 0 I �� <br />PERMIT APPLICATION <br />BUILDINGIMECHANICALIPLUMBINGISIGN/SPRINKLER/DEMOLITION <br />CITY OF EVERETT PERMIT SERVICES �j�07�—�/ <br />3200 Cedar St., Everett, WA 98201 - 425-257-8810 — FAX 425-257-8857 — www.evere a.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM /�Q�p ' O C <br />ADj�tESS:_ _ _ \. I� PROPERTVTA7(p PERMITt n/ -/N• <br />tor new conslruction: Shoh <br />PERMIT <br />Existing Use of Building <br />ubdivision Lot No._ (etlach copy ol long legal descdplion) <br />�' Phone/E-meil <br />CilylState/Zip <br />{'v L81Lic.# 3-� - �� �J <br />� � d'�1 PhonelEmall �� \L <br />CONTACT FOR PERMIT <br />PhonelE-mail ^`�Y�"1 L <br />CATION CONTRACT PRICE OF WORK ^ <br />>sed Use o( Building Shv'�1�4. � Ges Eledric�, otner <br />ng type: �(�, Single Family _ Duplex _Townhouse _ Multi•Famiiy _ Commercial <br />ofproject: _New,_,Addition _Remodel ,,�Repair_T.I._Sign_Sprinkler_Demolition_Change otUsa <br />ription of Work (adtlilional space provided on Iha back): <br />you started working without a pertnll �! �� � ���� <br />APPLICATION <br />otProJeel: _New_Addn _Altaretlon <br />Show Number (N) ol Rztures <br />AiC - air handlina ur <br />/$U <br />PERMIT <br />oiProJeet: ,_New_Atldn <br />Medical G3s <br />O�her: <br />V Repdr <br />� I NumberofHeads � � i v�ne�. ___ <br />I hereby ceAify Ihat I have read and ezamined this applica�ion and know Ihe same lo be Irue and cortecl. All provisions of lews and ordinances qoveming <br />ihis type of work will be complied with whether specifed hereln or not. The granting of a pertnil Aoes nol preaume to give authority lo vio:ete or cancel <br />the provision af any olher stxte or local law regulatin8 �onsiructlon or the peAortnance of conslruc�ion. That I am aulhonzetl by I�e owner ol thia property <br />to peAorm Ihe work for which application is made and I comp y with Ihe S�ale Con�radors Lew 7827 RCW anA 298200 WAC <br />`—� � (o �O 11 <br />OwnerlAuthorizadAgentSigna e Dale (RavisedY10f7) <br />