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f <br />1 <br />PERMIT APPLICATION <br />BUILDINGIMECHANICALIPLUMBINGISIGNISPRINKLERIDEMOLITIOIV <br />CITY OF EVERETT PERMIT 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 TO 4 PM <br />Iornewtonslmcli0n: Shotl <br />t ('I 4 � <br />ACTOR ` <br />i Z�{ � <br />T BUSINESS NAME <br />� � --1 � <br />DING PERMIT <br />Use o( Building <br />G <br />�.� <br />�LICATION <br />TAX p I r 17'ii ! � O.� <br />/' ( <br />No._ (attach copy ol long legal descriplion) <br /># <br />PRICE OF WORK <br />Proposed Use of �uilding � -" -- - — <br />i <br />Bullding type: _ Single Family _ Duplex _Townhouse _ Mulli•Family��Commercial <br />Type of proiect: _ New _ Addition _ Remodel _ Repair_ T.I. _ Sign _Sprinkler _Demolition_Change of Use <br />Desc�ip�io0 0( Work (adURional s ace providedon Ihe back): �v i l_.n Q�l� �C`� <br />7�� v �•,n 1�., :.�- � �" � <br />(�2� ��� I`�. ���. <br />� <br />Have you started working wilhoul a permit7 _YES �NO <br />MECHANICAL PERMIT APPLICATION <br />TypooiProJecL _New_Addn _Alteratlon_Repair <br />Shaw Number (R) o/ /ixfures <br />I AR` _ oir hnndlinn uni�s <br />Heat <br />Other <br />ISU <br />Heads <br />PLUMBING PERMIT APPLICATION <br />o1ProJoct: _New_Addn __Alteration_Repalr <br />Show Numbcr (M) of ffxfures <br />heater <br />Medical Gas <br />Other. �� �� <br />Other: <br />� <br />I hereby certify thal I have read antl ezamined this application and know ihe same to be true and wrrect. All provisions ot laws and ordinances goveming <br />this type ol work will be complied with whether speciGed herein or not. The granting ol a pertnil does nol presume to give authonty to violale or cancel <br />1he pmvision ol any other slate or local law regulating constrvclion or the periormance ol constmctioa 7hat I am authonzetl by ihe owner ol Ihis propetly <br />Io pedor x'fhe work !or which app�ication is made and I comply with ihe Slate Coniractors Law 1827 HCW and 296200 WAC <br />Ownar/Authoriz d Ag�ignature ' J Date (Revise07l1017) <br />