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PERMIT APPLICATION <br />BUILDING/MECHANICAUPLUMBING/SIGNISPRINKLERIDEMOLITION <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 ACCEPTED FROM 8 AM TO I PM y� <br />)DRESS: PROPERTYTA%p P RMITi n <br />%C) �.cJCTiYIor e AU� ___ ��A � ��C%7 � <br />1of new consiruction: ShoM PlaUsubdivision Lot No._ (atlach copy of long legel descriplion) <br />8 I LiC. # <br />BUILDING PERMIT APPLICATION <br />Use of Building Sin3,(3 Fi H�� �i � QP� �'t✓rn f <br />PRICE OF WORN <br />HEAT SOURCE: <br />'roposed Use of Building I �as tieanc,� umer <br />3uilding type: � Single Fami�y _ Duplex _Townh�o!use _ Multi-Family _ Commerciai <br />fype of project: _ New _ Addilion _ Remodel L Repair _ T.I. _ Sign _Sprinkler _Demolition_Change of Use <br />)escriptionofWork(addifionalspaceprovidedonfheback�: /,epq�n � 2ep�Atrmrnr oF �AO SNfPTRCCK, 2rPANL <br />?F G��i��ye �ih.11 FirMSi (jCpc.:r aF 8nrnnvo,�,� c�JAll� r/�t�.w+�i-v�,. F12 L�.�.inKy 20��+�1, <br />rnSM.Uc.frr•.� nF c�e��t fuNs. Tnelc.1/n}:e�. cf- f�yrr�s c..r�al<w �� drr/��+�.� <br />you aW�ted working without a permtt7 1C YES _NO <br />PERMIT APPLICATION <br />ofProject: _Naw_Addn _Alteration <br />Show NumberlNl o/ Iixturea <br />SPRINKLER <br />SYSTEM <br />PERMIT <br />ofProJect: _New_Addn _Alteratlon <br />Show Number (N) ol flxtures <br />Medical Gas <br />Other. <br />Other: <br />I hereby cenify �hat I have read and ezamined Ihis application and know the same to be trun and conecl. All provisions of laws aM oMinances goveming <br />this typo ol work will be complied with whether specifetl herein or noL The grantlng of a permi� does no� presume lo give authonty lo violate or cancel <br />Ihe provision of any olher state or local law reg�lating construction or Ihe pedormance o1 cons ruction. That 1 am authorized by Ihe owner of ihis property <br />to ped the wor� for which pplicalion is made and I comply with the Slale Coniracturs Law 18.27 RCW and 296.200 WAC <br /><�w��� �D f O <br />er/Autl rizetl Ag k Signatur Date (Revisetl1R017) <br />