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PERMIT APPLICATION <br />BUILDING/MECHANICALIPLUMBINGISIGN/SPRINKLER/DEMOLITION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 Cedar SL, E� erett, WA 98201 - 425-257-8810 - FAX 425-257-8857 - www.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />EADDRESS: PROPERTYTAXq �g RMIT# � <br />�.�n;. �-Jui �1 ��o. � �J ,.. ✓a�ar�rr n ;i1 v:4:r� (T 11l (�-"� -O'?a <br />lor new conslmction: Shor1 <br />OWNER li%ft/'v';' <br /><" <br />��� <br />NG PERMIT APPLICATION <br />Existing Use of Building � ��>> <br />Lc No._ (sltach copy ol long Icgal description) <br />Phone/E-mail �;��j- 3�f �- � �� � <br />aiy�siai�rz�a L` ✓CZF� l �,� ��.�0`t <br />LRILic.# <br />�PnonelEmail `iaS• �yg - ���� <br />CONTACT FOR PERMIT <br />Phonc/E-inail <br />CONTRACT PRICE OF WORK <br />Proposed Use of Building I _""—'�; `� -- — <br />Building type: � Single Family _ Duplex _Townhous= _ Multi-Family _ Commercial <br />Type of project: _ New _ Addilion _ Remodel _ Repair _ T.I. _ Sign _Sprinkler_Demolition_Change of Use <br />Descriplion o( Work (adddional spaceprovided �n tF,e back): <br />?>�.r /�V C /�C �jTOI�� <br />you started workinc� without a permit7 _YES �NO <br />MECHANICAL PERMIT APPLICATION <br />of Project:_ �New_Addn _ Alleration _Repair <br />Show Numbcr (p) of lixfures <br />I AIC - air handlina units <br />SPRINKLER I SUPPRESSION <br />Number of <br />PLUMBING PERMIT APPLIC� iION <br />ofProjac�: _New_Addn _Altoralion_Ropalr <br />Shnw Num6crlRl o/(ixfure5 <br />Medical Gas <br />Other. <br />Other: <br />I hereUy certily Ihat I have read and ezamined Ihis applicalion and know Ihe same lo be tme and corted. All provisions al laws and ordinances governing <br />Ihis type of work �vill be complied �eith �vhether speci6ed herein or noL The granting of a permit does nol presume lo give authority lo violale or cancel <br />the pmvision ol any olher state or lowl law mgulaliny censimclion or Ihe pertormanee of tonslmclion. Thal I ain aulhorized by Ihe onner of Ihis property <br />to per�6F� the work fur �vl ich app!ical� n is matle and I comply vrilh the Slale Conlractors Lmv 1827 RCVJ ana 296200 WAC <br />i _ �- <br />�� /„ / <br />!� �'(ll,,l� � c(Ji� . �—�' � <br />OwnorlAuthorizeJ Agent Sl�naturo Date (Remsed 2QG71J <br />