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PERMIT APPLICATION <br />BUILDING/MECHANICALIPLUMBING/SIGNISPRINKLERIDEMOLITION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 Cedar S, Everett, WA 98201 - 425-257-8810 — FAX 425-257-8857 — www.everettwa.ora <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 Phi <br />ADDRESS: <br />TA% p <br />for ncw constmction: Short PlaVsubdivi�icn Lo; No._ (e:;aU ccpy o` long 1e�21 descnptien) <br />BIJILDING PEi2MIT APPLICATION <br />Use of Building <br />'j� L&ILlc.k �l'i�-/�/�(�ti <br />�v (,(��� ��� Phone/Email y�" %7S� ^� <br />CONTACT FOR PERMIT �2yq� ���� � <br />ahone/E-m�ii — 7S li �% c � <br />CONTRACT PRICE OF VJORK ��.%OG. UO <br />Proposed Use of Buildino � czs� tiectrc_ utner_ <br />Buildingtype: ,�SingleF2mily _Duplex_Townhouse _MWti-F2mily _Commerci2l <br />Typeofproject: _New _Addition _Remodel Repair_T.I._Sign_Sprinklzr_Demolition_Chanpe ofUs'e/ <br />D-<scriptionotWork(additionalspaceprovidedonthe6ack): RC/�LAC� �jt��j��.l� J—iAr���� prr5 /70� <br />L��A rt--f TA�� �./,U�� fj �JP-ccJ ff YFj/Z �p /-jOi 6Vq ��� �{EA iTa�– S,� TE'+� <br />S�,ti'le LccAnorJ . <br />Hsvc you etarlcd ���orking without a permit7 _YES �IJO <br />MECHANICAL PERMI r APPLICATION r— PLUMBING PER�91T APPLICATION <br />ofPrejcct _fJcvi_Addn <br />Shovi Numbcr (.) <br />Heat <br />� Other <br />SPRINKLERISU <br />_Repalr <br />SYSTEM <br />ofProJeeh _Nc�.v_Addn _Alteration_Repair <br />Sbow Nuni6w (�) o! (ixtures <br />heat=r <br />Floor <br />Medical Gas <br />Other: <br />� Number of Heads I I I utner: <br />I herc�y ce ,�ty Ihat I Iuve reatl and exarnined this >pphca6en 2nd hnow the same tc be Ltie and correct. NI provisions c` I:::,s 2nd a�insnces cove r��r� <br />thi= type of vrork will be wmplled �Nth wfiether speufed herein or noL The Branting of e permit dces not presume lo Qive �:_ hci:y t� �Cc'o.fe c� c:r.c_' <br />the provision of eny olher stale or local law regulaling consWclion or the p dortnsnce of wnsWcOon. Thal I sm auNarize'_ ty C�.e c:.rz� C t-.'.s F�c;.c;, <br />to perjorm�he v+ork tor which ep(ji n s m tlysnd I wmFly wiN the 5 te ConG clors Law 1827 RCW snd 296.200 LV.�� <br />_ � � S, <br />-= - � �;�� , ,�, ��_ <br />05vnedAut orizedAgant5lgna uc - �- � Da1e (n-�.:=cd22G;;) <br />