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PERM�T APPLICATION <br />BUILDING/MECHANICALIPLUM[31NGISIGNISPF2INKLER/DEMOLITION <br />CITY OF EVERETT P[RMIT SERVICES <br />3200 Cedar St., Everett, WA 98201 - 425-257-8810 — FAX 425-257-8857 — www•evereltwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TD 4 PM <br />. PROPERTYTA%N �RM(IT�N � _ ^ � <br />tor n�w wnslrudion: S�at <br />� <br />PERMIT APPLIGATION <br />�u� <br />No._ (aUach cop, <br />il �r'�i,�% <br />;egal <br />�� <br />2��� <br />��r yrr��,��ier� <br />� PRICE OF WORK <br />:zis�ing Use ot Building <br />Gas Eleclric�� Othe� <br />>roposed Use of Building <br />3uilding type: ✓ Singie Family _ Duplex _Townliouse _ Mu11i-Family _ Commercial . <br />fype o1 projed: _ New ,_Addition _ Remodel _ Repair _ T.I. _ Sign _Sprinkler_Demolition_Change ot Use <br />)esaipllon of Work (atlCrtional space /���Oed on fM1e back�: ✓ <br />( is-�1 v'° <br />T�•.. r � fc: INi� ��s <br />�. vou started working without a permit7 _YES f NO <br />MECHANICAL PE RMIT APPL�cw� �un ........—..__ -- <br />TypeotProect: _New_Addn _AlGretion_ Repalr <br />o1ProJecl: _New_Addn _Alteratlon_Nepair � ��,,,,,,u�„„ner�nlalllNures <br />Medical Gac <br />Olher. <br />� Number of Heads - - � <br />I hereby cediry Ihat I have read and eMamined this aDPliutlon end know t�e same to be irue and mrrecl. All pwvisiom ol laws and ortlinances poveming <br />this rype of weB will be complied wilh whether speciGed herein or not. The gran�ing ol a permit dcea nol presume la B��e auinonty to violale or cance� <br />the provision o1 any olher state or local law repulating conslruttlon or lhe peHortnance ef consWd�on. That I am authonzed by lhe owner ol lhis {.roperty <br />lo peAorm N�nrork fqr wfiich applicalion Is made and I wm I Ih t e State Conirocton Law f 827 RCW and 2982D0 WAC <br />Iwl�i Q (O��O� IZ <br />Owner/Aulhotlzed Agent Signature <br />Dale (RevisM 7R�11) <br />