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C f <br />PERMIT APPLICATION <br />BUILDINGIMECHANICALIPLUMBINGISIGNISPRINKLER/DEMOLITION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 Cedar St., Everett, WA 98201 - 425-257-8810 - FAX 425-257-8357 - www.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />for raw <br />�const-urction�Short <br />is 1 awnotij l o') <br />/ v)(t <br />FF <br />PERMIT APPLICATION <br />IE Il)n`; ^''2- —2-Uu�uc I Ill' <br />_Lot No (attach copy of long legal descnp <br />Phone/E-mail S _z f 5 <br />city/State/Zip Fv6,2,--T7- / lyt�- 9S� <br />777-- <br />IL-s I Lic. p -Tt SR 1 <br />W IUyI� 7` C <br />Phone/Email ? � ^ 7 J 2 - <br />C NTACT FOR PERMIT <br />Phone/E-mail �U' 5 2 _St(• l� <br />CONTRACT PRICE OF WORK , I O <br />y <br />FINK <br />zisling Use of Building <br />' Gas �nE11CMc other"— <br />'roposed Use Of Building �7 <br />luilding type: `! Single Family —Duplex —Townhouse _ Multi -Family _Commercial <br />'ype of project: —New —Addition \/Remodel —Repair _ T.I. _Sign __Spdnkler_Demolition_Change of-TUsse <br />fescn�`� <br />plionof Work �%WrIT N U gl�'lIC -r-t ( 1 v <br />ZAo ` t"hF-!J CF "JF2 �Lhr� JJ <br />you started working without a permit? _YES '/No <br />of Project: —Now—Addn—Afteretion—Repair <br />SAnw Numhar /a) of hXrn.vs <br />TION <br />of Project —claw—Addn —Attention—Repair <br />Show Number (a) Of fixtures <br />Other Medical Gas <br />r ___...... -- r ....Mmma amnu GVQTFY Other: <br />I hereby certify that I have read and examined this appicetion and know the same to be true and correct. All provisions of laws and ordinances governing <br />this type of work will be complied win Whether specified herein or not. The granting of a permit does not prewme to give authority to violate or cancel <br />the provision of any other state or local law regulating construction or the performance of construction. That I am authorized by the owner of this property <br />to perfo he work for which ap�ion is made and I comply with the State Contractors Law 18 27 RC W and 296200 WAC <br />��'/C Cti 5A 1/ n 12 (Revised 2,2011) <br />Date <br />Owner/Authorized Agent Signature <br />\/`Z <br />