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PERMIT APPLICATION <br />BUILDING/MECHANICAL/PLUMBINGISIGN/SPRINKLER/DEMOLITION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 Cedar St., Everett, WA 98201 - 425-257-8870 — FAX 425-257-8857 — www.everettwa.org <br />pPPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM �� 1I `-� i� <br />_____" _ _ PROPERiYTR%M Pf�T�-!__�1 <br />iornewwnatrudion: ShoR <br />Lo� No._ (atlach copy ofbrp legal descriptlon) <br />Z� <br />PhonGE�mall � � <br />� (�L' crtr�sisiuziP - V2 <br />L& I Lic. ll �n/F �- Z- <br />i Phone/Email Z ' / ' S <br />CONTACTFORpERMI���Y���� . <br />GOh' <br />Na PERMIT �PPLICATION IcoNrruCTPRICEOF WORK <br />Usa oi Building <br />oposed Use of Building - <br />iilding type: _ Single Famity ,_, �)upiex _Townhouse _ Multi-Family _ Commerclal . <br />�pe ol project: _ New _AAdition _ Remodel _ Repair _ T.I. _ Sign _Sprink�er_Demolilion_Change of Use <br />�sc�iption ot Worlt (atlCilianal space provfded on (he 6ack) : <br />� �GqrLcy'✓D`Gr/aS/�'1G-lZr/C <br />ave you etarted working wilhout a permil7 ,_,YES LNO <br />MECHANICAL PERMIT wrP�u:w � wn �--•^-••-- ----- -- <br />o(ProJect: _New_Aadn _Alteretion_Repeir Typso(ProJed: _N�w_AdAn _AN�ntlon_.Repalr <br />c�.nur N��mhwr /A o/ flYfUfld <br />Gas <br />Other: <br />I hereby cetliy ihal I have read and examined 1�I5 appliwtion and know t�a same to be Irue and correc6 All provisiorm of laws enC ordinancee Baveming <br />Ihis lype of work vnll be wmplied wilh whet�er specifed herein or not. The granlin8 0l a permil tloes no� presume �o pive aulhonly to vloiale or wncel <br />Ihe pmvision ofjjj''ny other stele or locql iaw reyulaling corystructbn or Ihe peAormanca ol consWction. That I am authortted bY Ihe ow�r of thie property <br />to peAor hq(wrk lo� wh rA ap' ion le mada a� aomply with ihe Stale Coniraclon Law 1827 RCW and 298.200 WAC <br />� ,�- � �-!l /Z <br />ner/A horized gent alure <br />Date (Revised 7/2011J <br />