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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.evere�a_c <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />I�ESS: PROPERTY TA%p PFiFA��T R/' <br />� 02. �x=�".Fe 1 I ik IZ /��i <br />lor new conslruclion: Short PlaVsubdivision Lal No._ (a�lach copy of Iong legal desc�plion) <br />U <br />&ILic.# <br />��� <br />—�Sl� <br />.� � �,, K�� �r �� �- <br />BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK <br />Existir�g Use of Building HEAT SOURCE: <br />Proposed Use of Building Ges_ Electric_ Olher_ <br />Building lype: _ Single Family _ Duplex _Townhouse _ Multi-Family _ Commercial <br />Type of project: _ New _ hJdition _ Remodel ,_ Repair _ T.I. _ Sign _Sprinkl�r _Demolition_Change of Use <br />ription of Wor1c (addifional space p�ovided on fha back): �Cr� <br />� c,vc. A r�� t� F crn-s /-�u <br />Have you slarted working without a pertnit7 _YES �NO <br />MECHANICAL PERMIT APPLICATION <br />Typo of Pto�etl: __New _Adtln _Alterallon _Repair <br />PLUMBING PERMIT APPLICATION <br />of ProJect: _New _Addn _Alteratlon _Repair <br />Show NumberlM) o( /lxtures <br />Medical Gas <br />Other: <br />I I Number of Heads 1 I � """'' <br />I here6y cehify that I have read and examined Ihis applicallon and know Ihe same lo be true and correcL All provislons of laws and ordinances gaveming <br />lhis �ype ol work will be compl��.ed wilh whether speci�ed herein or not. The granting oi a peunil does not presume �o give authorfly to violale or cancel <br />Ihe provis�^� of any other state or local law regulating cons�ruction or the periormance ot construclion. Tha� 1 am aulhorized by Ihe owner of Ihis property <br />to pedo tpe work lor wh' h, icalion is matl� nd I comply w�1h Ihe Stale Contractors Law 1827 RCW and 298200 WAC <br />� / / <br />i �/f��%( ^i,� � � �'l/ <br />qwnedAu odzed Agent gna ��re <br />Date (Revised 22017) <br />