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� <br />� <br />PERMIT APPLICATION <br />BUlLDINGIMECHANICALIPLUMBINGISIGNISPRINKLER/DEMOLITION <br />CITY OF EVERETT PERMIT SERVI�ES <br />3200 Cedar St , Cverett. WA 98201 425-257-E3810 - FAX 425-257-8857 - �•,n�nv everethva or� <br />APPLICATIONS ARE ACCEPTED FROM 8 A61 TO 4 PM l�J� L� �- I I <br />ITEADDRESS: PROP(NIY7'� a PERrdI': _ <br />�a��3 � �,� �v�.� /,J L W61 tu -c�. ` <br />EGAL'u rew ccnsu�cbon Shcrt �'�a'P,�COwivr,n_ __ _____let :do ___ (anaU ccpY o1 iong iega� ar,cecPon� <br />�-oqa,e Z ✓PG/IAIAc <br />tliess <br />BUILDING PERMIT APPLICATION <br />Ex�Shno Usc c� Bu��d�ra <br />Prcposed Use o` �wiCing <br />��hcne�E-�nail /� QL �7 � ��! " � ��j � <br />�7,yr5taieiz:P��P�[ L�It� G%y7 �� <br />I & I Lr:. # <br />P��oraEmad �i6� � ,3� 5 - <br />CONTACT FOR PERMIT <br />PhnccrcT.n,al���-UG ����- �063 �C <br />� <br />CONI�RAC7 PRICE OF WORK <br />Bwld�ng type. _ Singie Fam�ty _ Duplex _Townhouse _ Multi�Fam�ty _ Com-�erciai <br />TyOe of prc;ect _ New _ Atldmon _ Remodel _ Repau _ !T I_ Sign _Spnnkler _DemohUon_Change ol Use <br />DeScnPUon o( Worie lec��r:oca�;Face OronCed on fne oack) R� . ��•C7� ..E jf �i� ��t�y, �'� �f�Y�t .%dS�C�{R LG •} <br />r� uc<z s 0 uiL � b�� w u �,t c.Gu C��-� �r �a�'�. <br />�� P ` <br />Navr, you started working wilhout a permit9 _YES ___NO <br />MECHANICAL PERMIT APPLICATION <br />7ypeofProjecP. _New_/+tldn _Altcralion_ftepair <br />Show NumbM (M) olOr(ures <br />— art handlina unds <br />av <br />lieal pump <br />Und healer <br />Boder <br />RefigeraLon <br />Wcodstove <br />� Ducimg <br />� Other <br />SPRINKLER / SUPPRESSION <br />� Numt�cr o� Heuds <br />, <br />PLUMBING PE121V11T APPLICATION <br />Typo ol Proiecl: _New _Adan _ _Alteralion _Repair <br />Show Numbcr (pl o/ Gafures <br />i Toa!et <br />Medical Gas <br />Other. <br />I r=iety ce�Jy Inal I have iead and eraminetl �his aCPlicalion antl Nnow Ihe same lo be irue anA correcl All provis�ans ollaws antl orainances govem�rq <br />im; rype ol work rnil �e comp �� with wdM�er specfed here�n or not The gr�nling of a pertnit Ooes not presume to g�ve authonty to vioiate or cancei <br />�n� � rovision ol any other s1 .ie or local law regulatinq constmclwn or the pe�loimance ol eonsliuc6on Thal I am aulnorized by ihe ov.rer o� Inis pwpe�;� <br />�u � e��o�m Ihe wo�k te whic� application rs maae and I comply wilh Ihe Slale Contraclois Law 1B 27 RCW and 296 200 WAC <br />�--C'Gl/1/lL ��i�� /v - �� �/ �i <br />OwnerlAu�hq(¢ed Agent Signaturo Cal� iro���sr� ?-2Jt t) <br />( <br />