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� <br />l <br />PERMIT APPLICATION <br />BUILDING/MECHANICALIPLUMBING/SIGNISPRINK�.ERIDEPdOLITION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 Cedar St., Everett, WA 98201 - 425-257-8810 - FAX 425-257-885Y - etiww evereriwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM ��) S—� Z <br />� <br />brnewwnstructiorc. Shart <br />��-� n� <br />L �-�'- <br />W" 1 <br />ILDING PERMIT APPLICATION <br />Use of Building <br />i rT,i� <br />Lat Na._ (alta�h Apv a� �ong legal tlescription) <br />ione/E•mail y��� — �� � — �� �v <br />tylStatelZip rl(E � E t'�` � L'�%�' I C a��� <br />8 I Lic. # <br />��'lakc n�� a�i � i WA `iisc4:� 1: <br />:�a �,- -„ � - -� <br />ONTACT f�OR PERMIT <br />�one/E-maA <br />ONTRACT PRICE OF WORK _� �,Ji� • — <br />posed Use of Buildin i "'�4— "` "-- ""` — <br />Iding type: Sin Fami y_ Duplex _Townhouse _ Multi-Family _ Commercial <br />�e of project: _ New _ Addilion _ Remodel _ Repair _ T.I. _ Sign _Sprink.ler _Demolition__C�ange of Use <br />�criplion of Work (nddifional space pmvided on fhe 6ackJ: <br />rG�)�i�« c�c�S �.��nv�c��� W�Ci� 5����nL <br />�e you started working without a permil? _YES �NO <br />PERMIT <br />olProject: _New_Addn _Aiteratio�_Repair <br />Show Number (M) ol �xtures <br />� NC—airhandlinaunits <br />SYSTEM <br />PLUMBING PERMIl APPLICATION <br />olProject: _Naw_Addn _Altention_Repalr <br />Show N�mber IMl ol fixtures <br />Medical Gas <br />Other: <br />� Number of Heads I I I �mer: <br />I hereby cetliry lhat 1 have read and ezamined ihis appllcation and knowthe same to be Irue and wrrecL NI provisions ol laws and or0i,mi.xs goveming <br />ihis type of v.nrk will be mmplied with whelher speufied herein or not. The gran4ng ol a permit dces oat presume to give aulhodty to violate or cancel <br />Ihe provision of any other stale or lowl law regulating wnslruction or the pedormance ol conslruction. That I am authonzed by Ihe ovmer ol this pmpetly <br />lo peKortn lhe xurk Por which application is made and I comply with the Slate Contraclors Law 1827 RCW and 296.200 WAC <br />� �-- t�S�l�J�1 �-- <br />OwnerlAutt dzed Agent SignaW re Dale !Revised 2 2071) <br />