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PERMIT APPLICATION <br />BUILDING/MECHANICALIPLUMBING/SIGNISPRINKLER/DEMOLITION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 Cedar St., Everett, WA 98201 - 425-257-8810 — FAX 425-257-8857 —www.everettwa.org <br />APPLICATIONS ARE ACCEPTEO FROM 8 AM TO 4 PM <br />(or new construction: Shod <br />��V C � <br />division Lot No._ (attach copy ol long <br />� �� , PhonelE-mail � <br />� y � . �� CilylSlate/ZiP � [�� " , / <br />'(l�/ %� � L & I Lic. # <br />l,�-.J� PhonelEmai� �oS7 � <br />BUILDING PERMIT APPLICATION CON7anc7 PRICE OF woRK <br />Existing Use ul8uilding �r <br />HEATSOURCE: <br />— �� <br />Proposed Use of Building '"""— ---`��— � <br />Building type: _ Single Family __ Duplex _Towniiouse _ Multi-Family _ Commercial <br />TypeofproJect: _New _Addit(on _Remodel _Repair_T.1._Sign,_Sprinkler_Demolition_Change ofUse <br />Desf:ription of Work (addilional space pmvided on fhe back): <br />�,>>ti�«; � /�.a.«<���— — � � �p./ll 7 <br />�� f�C <br />� you etarted workMg without a permit? _YES �_� NO <br />MECHANICAL PERMIT APPLICATION <br />of ProJoct: _Now _Addn _Alteratlon _Repalr <br />PLUMBING PERMIT fiPPLICATION <br />o1ProJect: _New_Addn _Altention_RepNr <br />Chow NumberlM) ol flrtures <br />_ � Olher <br />9 <br />I Number ol Heads — — <br />I hereby certify thnt I have read ana e.amined Ihis application and know Ihe same lo be Wa and cortect. All provisions of laws and ordinances poveming <br />this type ol work will be comphed with whelher specified herein or not. Th� granting ol a permit does not presume to B��e authority Io violate or cancel <br />the piovisian ol apy other slate or bcal law regulaling conslmclion or the pedormance ol conslruclion. That I am aulhorized 6y Ihe owner of this propetly <br />lo pertorm Iha �rk (orwhich 3pplicalion is made and I comply wilh the State CoNraclors Law 1827 RCW and 296.200 WAC <br />. �ly,�� // , <br />� �i �� � ,L �'�� (R9visetl fY10f0) <br />Owner/AuthodzeN�Agen[ SlgnaWro Oate <br />