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PERMIT APPLICATION <br />BUILDINGIMECHANICAL/PLUMBINGISIGNISPRINKLER/DEMOLITION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 Cedar St., Everett, WA 98201 - 425-257-8810 — FAX 425-257-8857 —www.everetlwe•ur9 <br />APPLICATIONS ARE ACCEPTED FROM ! AM TO 4 PM <br />io�ia <br />lornewcomWdbn: Stiort <br />BUILDIN6 PERMIT APPLICATION <br />use or eufidirg <br />���a���a� <br />��L'J�-1 <br />PRICE OF WORK <br />� �i <br />/.71��-lCtl.v — ��r+1 S c I C <br />�690 <br />Hea,r souRce: <br />aed Use of BuiWi�g S tiZ � Gas Ele�3rie rnner <br />ng type: ✓Sirgle Family _ Duplex _Townhouse _ Multi-Famfy _:.ommerdal <br />otproject ✓New _Additlon _Remodel _RepNr_T.I._Sign ✓prinkler_DemolWon_CMnps ofUss <br />esaiption of WoAc (eddtanN spece Proviaed aa Hre badQ: <br />/�v5r�4LC. Fi2K SPRINKL��YZS /� <br />aLrted working wHhout a partnk? _YES �O <br />ofProJ�et _Naw�lddn _Alt�ntlon_MWir <br />Shar� Mwnbr f/1 o/N:ture� <br />✓�/L� S � l�0 N �A-J 5 � <br />ofPro�CL _Nw'+—Addn —AMw'Nw^—R�Wir <br />_ I aner <br />I Zt! Numbar ol Fieads I I — � <br />I hereby certity tiv�t 1 have reaA anU examined lhis appllralian and know the same to be Irue and owre�. All provisions ot laws and ordhiaraea Yuvemin0 <br />lhis type al rrork will bo complied wilh whether spedfied hereln or noL The pranting of e pnrmit does ral peaume to qNe aNhority to violate a oncel <br />tha provision of any other stete or Iocai law regulaling construdion or the peAormance ot constnktion. Thet I am aMaized Dy ihe orrier o1 thb M�I�Y <br />lo pertorm the work fw whidi appliwlion de and I eanply wNi lhe S) a�e Conlradas Law 18.27 RCW atd 296.200 WAC <br />�� 1�n70/�r� <br />OwmrlAu orizad A{pnt SlpnaWn I'� Date (Revised fYM701 <br />`/� <br />