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PERMIT APPLICATION <br />�C,�L��-�.i�V'��=�'; j� <br />u�� OCT 3 1 2011 J <br />PUBLIC �aJ�ifZl�.�� <br />BUILDINGlMECHANICAUPLUMBINGISIGNISPRINKLERlDEMOLITION �,I <br />CITY OF EVERETT PERMIT SERVICES /I -"- GD/,� <br />3200 Cedar St., Everett, WA 98201 - 426-267-8810 - FAX 426-267-8857 - wyvw.evereriwa.org `, �� 6(( 7 <br />APPLICATIONS ARE A C C E P T E D F R O M e A M T O 4 P M <br />enneeaa. PI10P[RIYTAXN PCPMIT,M ���� n., i <br />1IX IItW COfID�NCIbfL' B�IOf� <br />N <br />7 �ho-I u pPG� f <br />ACTOR I� N telM� L <br />i ii?� ��H <br />Rosrx�ood. �{ow�a G�,e.� <br />BUILDIMO PlRMIT APPLICATION <br />=f7• a�ltot No. 4� (a1uUi mpy of Wnp lepW desalptlon) <br />2 tTonelE-mall t ^ I 8 <br />Ciry/State/Lp �VGR! 2� <br />�aiuo.rt�bt� Go24� 4-'f-t1 <br />IALi �1B Z03 PhonalEmed �25 2aq • 4-4� 4- <br />�,M Ka�rk�p,+-oa 4vtacs aaM <br />PhonelE.mall 1{.2Qj �i' � <br />CONTRACT PRICE OF WORK <br />:�bting Use af Bullding %� d bl (:- Cf1 RE. ii'O 1'�1 e- HEAT SOURCE; <br />'ropooad Usa of BUlltllnp 5 R WlG Gas, eedric �/ otner <br />Wlldlrgrype: ✓SingleFamlly _Duplex_Townhouse _Multl-Femily _Commerdal , <br />ypeofproJed: _New _Addltlon _Remodel _Repelr_T.I._Sipn_Sprinkler_Demollpon_Chenge ofUu <br />)eetrlpli0n o} Work (edA'tbnel spxa provided ai the 6eck): <br />DoconS�RuvHon o� M�c►tk-n%cal. � Pluwtl�ino� rF-nd Fa�r�.ting <br />oF �4+t��►te4 yr��rtge. <br />lave you sGrted waking wlthaut � permlt? ✓YE9 _NO <br />PERMIT <br />Proj�n: _Naw_ntldn _Alunllon_R�peU . I ITyp�MPro�aat: _Naw_AtlOn <br />Other. <br />I heroby teNy t�al I heve rad end examined Iho eppl'�cation and know the ume lo be true and cotteci Pll proWalw ol Wa �nd ordinanat powrnlrq <br />lnls rype ol uo,1c w1uDe eanpned w1U+ vfielher apeU�laC herNn or not. The ynnUnp ol a perMt doee not Pm�� ro ave authoAly b videle or anal <br />the provision of arry olher sl�ta or laal law rp�Jallnp con�wdim ar Ih� W�rtnanu ot toneWctlm.lMl I am aWtarized by tl» ov�na d Mis propetN <br />to pertorm the v.arh Wrw1i .1 eppliutlon ie made end 1 comply vA1h Ihe 6ule ConVsdan Law 18.27 RCW aM 298.�00 WAC <br />6, • 6- l� <br />pwne uth AgmlDlpnaNn Date (RlVlsd?/I011) <br />lS� S D l <br />!� <br />