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PERMIT APPLICATION <br />BUILDING/MECHANICAUPLUMBING/SIGN/SPRINKLER/JEMOLITION <br />CITY OF EVEREIT PERMIT SERVIC[S <br />3200 Cedar St., Everett, WA 98201 - 425-257-8810 — FAX 425-257-8857 — www.everettwa.org <br />;,PPLICATI4NS ARE ACCEPTED FROM 8 AM TO 4 PM <br />l D �/b <br />lor new consWdion: Shorl PI <br />! /��1�? �NS7- <br />s 7-z ,��c�c�e <br />ACTOR .QOg/NSc <br />193�J /2-4 <br />f/- 303 �CIryl5latetip �7)mJ.t.qS, c�-F <br />PERMIT APPLIGATION <br />F�cisting Use o( Building <br />Use of Building S Fi2. <br />Phone/Email <br />PRICE OF WORK <br />9�0 <br />/-7C�Y�.LSt'.v — �u+�t S c. t C <br />y 6 :'O <br />HEAT SOURCE[ <br />ng type: ✓S(ngle Family _ Duplex _Townhouse _ Mutti-Family _ Commerdal <br />of project• ✓N�w _ AddiUon _ Remodct _ Repair _ T.I. _ Sign ✓prinkkr _Demolition_Change o( Use <br />escnption of Work (addrtronai spnce providedon the back/: <br />/n/$i,4CC. Fi2K SI�R.��K�L72S /i✓ <br />you sqrbod working wilhout a pertnit? _YES V NO <br />MECNANICAL PERMIT APPLICATION <br />ofProJect: _New_Addn _Alteratlon_Repair <br />air <br />Num�erofHeatls <br />�NL�ti 5 � (��v r� ��4-t) 5 � <br />PLUMBING PERMIT APPLICATION <br />of Projoct: _New_Addn _Allsntlon _Repair <br />Show N�mber (N) of Iixtures <br />Other <br />I liereby certity tl7a1 I baoe reatl and examined this appllcation and know the same lo be true anA corted. All provisions o11am and ordinarKes goveminp <br />Ri�s rype of woiic will bo rnmplied vrith whether spedfied herein or noL Tha granliig ol a permit does nol prusume to give authwiy lo violato or cancel <br />the pmvision of any other slate or loql law regulating consWction or ihe performance ol [onstnution. ThaI I am authorixetl Gy ��a owner of �hls propetly <br />to pe�Porm Ihe woik lur which applicati is made ana I wmpty wi0i the State ContraUors Law 18.27 RCW and 296.200 WAC <br />.�-��--2-� 1 �j � �I L- <br />Ownar/Auth d Agent Signature Dale (Revlsed 7?/lOfO) <br />��� <br />