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PERMIT APPLICATION <br />BUILDING/MECHANICALIPLUMBING/SIGN/SPRINKLERIDEMOLITION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 Cedar St., Everett, WA 98201 - 425-257-8310 - FAX 425-257-8857 - ww�v.ev1e.r'ethva.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM GYV_I Z D ' Dfl <br />rnx u <br />br new constmction: Shod PlaVsubUivision LOI No. _(allaeh eopy ol long Icgal <br />� <br />� <br />BUILDING PERMIT APPLICATION <br />Use of Ouilding <br />& I Lic. # <br />PERMIT k � <br />' - <br />descrip�ion) ��y p(. <br />. ..,[ ' Y>r'w�G (-Cn <br />�NTACT FOR PERMIT [,� y,� ��4 _ �.t� �'`� <br />,� 7 <br />/� -. ;,'rC!✓ /� r Q <br />.nn�c�l�maiflc/ J:.L�C />,�NYiii�i�lb� <br />PRICE OF <br />HEATSOURCE: <br />�sed Use of Duilding ���� l' �/ S FN � Gas_ [lectnc_ _ Other_ <br />ng type: _ Single Family !� � Duplex Townno�usLe _ Multi-Family _ Commercial <br />of project: _ New _ Addition �Remodel = Kepair _ T.I. _ Sign _Sprinkler _Demolition_Change of Use <br />ription o( Work (adtlRional spaco provided on the back): ,� t/a � � rU /� ... _ �; .E..t �'��( S�Tf/� ��� �! ��� ��t � I <br />i-y /� <br />��u�Kd,p R�cr�;�r� /�1ew- �k�'i-���j� {J'ia�c- R��-;tl'� (GC��S��&,�'{f:ti� UN> <br />9��j�Y�t'�K�L'� ��I.�Mi�{f( � `� <br />you siarted w r Ing wi hout a � c mit? V rES _NO <br />MECHANICAL PERMIT APPLICATION <br />ofPrc�ect: _New_Atldn _Alteratlon_Repair <br />Show Num6erlql o/ /ixfu�e5 <br />RISUPP <br />Number <br />PLUMBING PERMIT APPLICATION <br />ofProJecl: _Now_Addn _Allcratlon_Repalr <br />Show Numbrr (N) o//ixfurcs <br />Medical Gas <br />Olher <br />Other: <br />i i.�.�mLy ceillry ihat I have read and examined Ihis applicalion and kno�v the �ame lo Ue true and correcL All pmvisions ol laws and ordinances yoverning <br />e��. iype of work will be complied with whether specified herein or nol. 7 he granling of a permil does nol presume Io give authorily Io viol�te or cancel <br />,. �. crovision ol any olher slate or lowl law mgulaling construction or Uie peAormance ol conslmction Thal I am authorized by Ihe o�.mer ot this pwpedy <br />� u �: rilorm Ihe work lor �vhich applicalion is made and I comply with the State Contracrors Law 1827 RC1N and 29u100 WAC <br />�.a�-----z�r��—� v!�/ao�� <br />Owner/Aaliiorized Agent Signa�urc ° Date <br />(Feo-�sed �2011J <br />,/ G <br />