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PERNiIT APPLIGATION <br />BUILDING/MECHANICAL/PLUMBINGISIGNISPRIRIKLER/DEMOLITION <br />CITY OF EVERETT PERMIT SERVICES 3- a 3-��- <br />3200 Ceiiar St., Everett, WA 98201 - 425-257-8810 - FAX 425-257-8657 - www.everethva.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />��(,( Y'r�3i.�.� <br />lor r�ev� conslrudion: Shoh <br />vi, <br />37� RUcK(uc <br />PERMIT APPLICATION <br />Existing Use of Building �-"'�- z- <br />No._ (attaU copY ol long legal <br />PRICE OF WORK <br />� <br />2S0 <br />Proposed Use of Building - �- ' ' ' � """— -'--'�'-- -��---- <br />Building lype: _ Single Family _ Duplex _Townhouse _ Mulli•Family _ Commercial <br />Type of project: _ New _ Addition _ Remodet _ Repair _ T.I. _ Sign _Sprinkler _Demolition_Change of Use <br />DescriplionafWork(atlOrtiona�spaceprovidetlontheback):��... ! �� �w��uy /�/7C1�� �7`�''7""'� <br />tt���v <br />you slaAed working wilhout a permit7 _YES _NO <br />PE RMIT <br />otProJect; _New_Addn _Altcrotlon_Repalr <br />PERM IT <br />o1ProJecl: _New_AOdn _Alleration_Repelr <br />snnw Num6er IN1 0l flxfuree <br />N71S� <br />Gas <br />I hereby cerliy that I haw read and ezamined this appliwtion antl kna.v the sama lo De in+e antl wrrcct. All pmvisions ol laws antl orCinances goveming <br />this type ol vrork will be complietl wlh whether 5peciGetl herein or nol. The B�anting ol a permil does nol O�esume lo give authonty to violate o� cancel <br />lhe provision of any ot�er stata or local law regulating consWclion or Ihe peAo�mance ol consWction. That I am authorized by tha owner ol lhis pmperry <br />to pedorm Ne �wrk for which appliwtion is maae and 1 comply with Iha State Conlraclon Law 1827 RCW and 298.Y00 WAC <br />/� 3-Z3-/L <br />U f.J <br />Owner/Aulhodzed Agent Siguaturo Uale (ReWsed 7l1011) <br />