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PERMIT APPL�IC�ATION <br />BUILDINGIMECHANICAUPLUMBINGlSIC NISPRINKLER/DEMOLITION <br />CITY OF EVERETT PERMIIT SERVICES <br />3200 Cedar St., Everett, WA 98201 - 425-257-8810 - FA�: 425-257-8857 - www.everettwa.org <br />' APPLICATIONS ARE ACCEPTED FROM B AM TO 4 PM L� �- a a"�� <br />fornewconstrudion: ShortPlaVsubdivision:+VR�N <br />t P2o� � �...e�� +�t.� � -rti-► <br />I$ol L�...�n p�n�� Sw. <br />'��t'� N 7.. c� �l S� l..-rA-�1'i3 <br />lUILDING PERMIT APPLICATION <br />I Lic. N <br />L' <br />� �aSO I�'o1- I �If�`� ' <br />i.�}! (ettach copy ot lorq lepal tlescription) <br />��,..a-w .-1 . � �4 R °� u S"} <br />PhoneJEmail <br />PER T <br />�l.1�'iH-C./ l�-1�dl�t i <br />�-s-�z .-�3� � <br />PRICE OF WORI i'� 0, Jo a <br />Ezisting Use of Building �� �� G�'L— HEAT SOURCE: <br />Proposed Use of Building �� p� �� Gas EiearieX Other <br />Buildingtype: _SingleFamNy �Duplex_Townhouse _Multi-Family u Commercial �� `�"�A' <br />Type ot project: _ New _Addition _ Remodel _ Repair � T.I. _ Sign _Sprinkler _Demoiition_Chenge of Use <br />Descnptiono(WOrk(edditionalspeceProviOedonthebackl: W,��t16�Lt.AL T•Z. ��-WPI�-Si1(,�.L'SU.vA 1.., 13U1LU <br />��� �v��-J����� w�Hic."t-�jqw F_@/�-1�I,1 �,,.�Kw 1.1F�11't1.t-� S��i"�7), <br />iIJ C�In�I�L i.� J�� �A'L.eJ�Jl;S "i@r� A*1 T� IN�[Y7\�-AL, <br />Have you atarted working without a pertnit7 _YES _NO <br />PERMIT APPLICATION <br />ot ProJact: _New_Adtln _Altantion _Rapeir <br />Show Number fN) o/ flxtures <br />Heads <br />PLUMBING PERMIT <br />olprojact; _Naw_Addn _AltarNion_Rapair <br />Medical Gas <br />Other. <br />Other. <br />I hereby cerGry lhat 1 have read and examined this appli�ation and knav Ne same l0 6e true and carreci All provisions of laws and ordinances govemirg <br />this type of rork will be complied vnth whelher speafied herein or not. The grantlng of a pe�mit tices (wt presume to give authonty lo vidate a rancel <br />the provision ol any other state or locat law regulating consWction or Ihe peRortnance of consWction. That I am authorized by the ovmer W this properry <br />nto perform Ihe rk r which appliration is made antl I compy with the SWte ConUactors Law 78.27 RCW and 296.200 WAC <br />l �� �� <br />OwnerlA horized Agant Signeture Date (��� ��»i <br />T <br />I �Z <br />