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I I I G�(201 I 1{F,U I I:50 P:A% d:'� :4i [1 70��5 «:A At�111i'+11 I;nti '�]- 00? DOG <br />PERMIT APPLICATION <br />BUILDING/MECHANICAL/PLUMBINGISIGN/SPRINKLER/DEMOLITION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 Cedar St., Everett, WA 9820� - 425-257-8810 — FAX 425•257-8R57 —�tiavw.everetlwa.org <br />APPLICATIONS ARE ACCEPTED �ROM 8 M7 TO 4 P�d <br />(ornewccnsimtlion. Shotl <br />�. <br />`G� ���3 IPROPERTVTAXp <br />a� <br />LDING PERMIT APPLICATION <br />[zi,ting Usc of Duliding <br />.i���.ttr <br />`�f20 j <br />I M1111- C�t�• <br />_(atlach copy of long legal descnDticn) <br />S 339 • is.29 <br />1'� GU19 ���� <br />h���i /3L/J - <br />� ��,�.tir,� �-usz, �.?s=Sl a2S'S1 <br />PRICE OF WORK �30U <'" <br />Proposed USC O( �ulldinc� __ � oas_ c��������_ <br />Building typr. _ Single Family _ Duplex_Townhouso _ Multi-Family _ Commeicial <br />lype of projecL• __ New _ AddiGon _ Remodel _ Repair _ T.1. _ Sign _Sprinkler _Demotition_Change of Use <br />Descfiplion o( WOrk (add�lional space p�ovided on (he bacAJ: <br />Havo you started working wilhoul a permil7 _7[S _NO <br />MECHANICAL PERMIT APPLICATION <br />TypnofAroject: _Now_AdJn _ Iferatian_Repair <br />Show Number (p) ol frrturos <br />NC — air handlinp uni�s <br />_�_ ForCMairs slems <br />Gas pipl�o <br />Water heater <br />Gas frteplacc <br />Gas ran c <br />Clothes d er <br />Runoe hood <br />[xhaustfan <br />I ieat pum <br />Unit healer <br />l3oiler <br />Relriocralion <br />Woodstove <br />Duciing <br />Olhcr <br />SPRINKLER / SUPPRESSION SYSTEM <br />Number of Hcads <br />PLUMBING PERMIT APPLICATION <br />of ProJect: _New _Addn _Alleration _Repalr <br />Show Numbor fpl o/ firfures <br />Clothes washer <br />Water heater <br />Sink (service/ba <br />l3ar.Allpw preve� <br />Urinal <br />DrinAing Pounta <br />Flocr diain <br />Grcasc trao <br />Roof drains <br />A7edical Ga, <br />Other; <br />Other. <br />I hweby cenify that 1 have read an7 ezaminad Ihis npplicotion entl kaow the, samo to be Inie an3 cortecL All p•cvisions ol �m�s and wdlwnces go�em�ng <br />Ihis type of ��ork �II be complied n9h xhether sFeci�ed herein or nol The grdnting ol a Oeimit tloes noi presume lo yive authoriry to violate or wncel <br />tho provision ol ny other s ate er Iowi lawrogulating conFlructicn or Ihe pedormance of consimction. Thal I am authonzed ty the cwner cl lhis pmFenY <br />lo pedo i wrk,for nfilch a � cation s made asd I complY �.+Ih the �tate Conlractors Lmv SB27 FCW . nd 23G.^.00 �"��C <br />%� ��: � ' �L�7� Il �V 201 � <br />Ownu �Auihorizod�l S' nalure Da u (Reri;ed "✓2071) <br />/ <br />I/ <br />/ ` <br />