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From <br />o2�c� •�0�2 i�:so aaos P.00zrooz <br />S�`iG'i3 �� <br />PERMIT APPLICATION <br />BUILDING/MECHANICAL/PLUMBING/SIGN/SPRINKLER/DEMOLITION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 Cedar St., Everett, WA 98201 - 425-257-8810 — FAX 425-257-8857 — www.everethva.� <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM ��- <br />JDRESS: PROPEPTVTA%N PEt+MIT <br />7� N0.Y'hcxk{�f� �1o��50U3�31oC� MIZO�G <br />lor naw conalructlon: Short PIaV�uDOivislon lot No._ (attac� wpY of lon9 �9a1 aesv�ption) <br />G PERMIT APPLICATION <br />Use ol Building <br />PRICE OF <br />(03(0•7 <br />�roposad Use �o/f'Uullding � Ges.J� Ekwttic_ oihor_ <br />3uilding ypa: G Single Family _ Duplex _Townh�youse _ Mulll•Femily _ Commercial <br />rype of projad: _ New _ Addition _ Romodet �y Repetr _ T.I. _ Sign _Sprtnkler_Demolttion_Change of Use <br />7escriptionof Work(edtlifionelspaceprov/dedonfhobeck): <br />�ennc�el re�lctce 9 as v.� a-;� I� a-}�'. <br />atarted worklnp wilt�out a pertnit7 _VES _NO <br />PERMIT APPLICATION <br />a1ProJocl: _Naw_Addn <br />� <br />G <br />PLUMBING PERMIT APPLICATION <br />ofPmJacL• _Naw_Adtln _AlteroUon_Rcp�ir <br />Medical Gas <br />Olhor. <br />I hareby certity lhat I �ava roed and ezaminetl Ihl� applic�tlon an0 knowihe sama to be we �ntl cortect. All provisbns ol lawa anC adinancus governinp <br />Ihis (ypp of �wrk will be complled with whet�er specified henin or not. 7he g�eMlnB ol a petmil dooa nol presumc lo yive authoriry to vblata or pnml <br />the provision of eny oNer slato ar bcal law rcpulaling cansWCUon or I�e pcAormance ol conaVuction. That I em authorizetl Oy Iha oMner ol this property <br />lo pcAorm Ihe Hork lor �Mich applicalion ia mada and � comply �tith Ihe Sta�e Contraclon Lew 18.27 RCW antl Y06.2D0 WAC <br />� w/' Z7 2 <br />n�rlAuthorindAgent gnature Dato (Revlsed7l1011) <br />