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PERMIT APPLICATION <br />BUILDINGIMECHANICALIPLUMBINGISIGN/SPRINKLER/DEMOLITION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 Cedar St., Everett, WA 98201 - 425-257-8810 — FAX 425-257-8657 —vvww.evecrettwa.org <br />ApPLICATI0N5 ARE ACCEPTED FROM 8 AM TO 4 PM J— S'�I _� <br />PROPERNTAXp P MI,ZOS --�?� C <br />ADDRESS: !rt ;'1 CQ-f4� S.�- S'4— <br />� Y `t J <br />newwnstruclion: ShoA <br />81 <br />re <br />Cc,,�-e <br />PERMIT APPLICATION <br />Use of Build!ng <br />_Lot No._ (aliach copy ollong le�al <br />klele w <br />a61-�81fi <br />PRICE OF WORK <br />HEATSOURCE: _ <br />?roposed Use of Buitd�:�g_ '--- <br />Buildinglype: _S�ngleFartiily _Duplex_Townhouse _Multi-Family _Commercial . <br />iype of project: __ New _Addition _ Remodel _ Repair,_ T.I. _ Sign _Sprinkler _Demolilion_Change o( Use <br />DeSCription of Work (additional space provided on Ihe back) : I LSC i�� r� <br />r�,io W��k be�n� dovle - Chr.�n�iv�� f�ame o� b> > <br />Have you started working without a permit4 _YES _N� <br />MECHANICAL PERMIT APPLICATION <br />o� uMgING PERMIT APPLICATIO <br />ofProJecl: ,_New_Addn ,_Alteration_Repair <br />_New_Addn _Alteratlon_Repair <br />Other: <br />Gas <br />I hcreby certiFy that 1 have read and e<amined this application and know the samo to 6e tme and r.orrecL All provisions ol laws and ordinances goveming <br />this type of work will be complied vnth whether specified herein or not. The granling of a permit does nol presume lo give aulnoriry to violate or cancel <br />the pmvisian ol any other sta!e or local law regulating conslruction or the pedormanco ol consWction. That I am authodzed by the owner ot Ihis pmperly <br />to pedorm lhe work for which application Is made and I wmpN �^�h the Stale CONractors Law 1827 RCW and 298200 WAC <br />,� �s-lo-/2 <br />OwnerlAulhorized Agent Signaturo <br />oatP (Revised 7/2o11J <br />,�� <br />