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PERM17 APPLICATION <br />BUILDING/M�CHANICAL/PLUMBING/SIGN/SPRINKLER/DEMOLITION <br />CITY OF EVERETT PERMIT SERVICES S� 3•�� Zi <br />3200 Cedar St., Everett, 1NA 987.01 - 425-257-8810 — FAX 425-257-8857 — www.everettwa.org <br />APPLICATIONS ARE ACCEPTEO FROM B AM TO 4 PM <br />Ll <br />fornewwnsWction: Short <br />L\i <br />L+-� <br />BUILDING PERMIT APpLICATION <br />Usa of Building <br />�al No._ (altach cop <br />�one/E-mall ��`, � ��� <br />ty/State2iP �1�. ( ��"� <br />aiu�.a e lic <br />?j y Phone/Email t <br />ONTACT FOR ERMIT <br />�ulie C'as�f �2 <br />,o�eie•men T�, I�c GC� -� <br />ONTRACT PRICE OF WORK <br />IonB �Wal tlescr�plian) <br />(�3(0• <br />Proposed Use of`Building ""' "�"."— '"..._.— <br />Building type�. s Single Fami�• _ �uplex _Towiihouse _ Mu1ti-Famiiy _ Commercial <br />Type of projoct: _ New _ Addilion _ Remodel _ Repair _ T.I. _ Sign _Sprinkler _Demolition_Change of Use <br />Descriptlon of Work (aad/tlonal space pmvidxd on Ihe back): , <br />��r��;� �% �e��\c�ce �,�C��e,c ��c.-�e� ��a c�rv� locc��i�1 <br />you slarted working without a permlt� _VES _NO <br />CAL PERMIT APPLICATION <br />ot Project: _New _Adtln _Aitoratlon _Rapelr <br />shnw Num6er !MI of flxtulub <br />`iGl )"�C�( <br />PERMIT <br />ol PrOject: _NOW _AtlOn _Alteratlon _Repair <br />Show NumDer (N) o/Aatures <br />Medical Gas <br />Other. <br />G a�'�'1 <br />I �erehy certity that I have read and examinea lnis appllcation anC know lhe same ro 6e tnre antl corred. All p�a�islons of lavrs anE or0lnances goveminq <br />Ihi; type ol wurk vili 6e complie0 wilh whelher specified herein or nol. The grenling ol a pertnit does not p�esume lo B��e authority to violate or cancel <br />ihe provision ol any alher slale or tocel law regulatin9 conslmction or ihe pertwmance ol wnslrudion. Tnet I em euthoriied by iha owner ol this property <br />to purform the v.ork for w»ich applicalion Is made and I comply wilh Ihe Stato Conlrocton Law �827 RCW and 296.200 WAC <br />,r/�; �'�1��- ��3�I � <br />iwr/AuUarizeJ Agant gna[urc ate (Revisetl7l1017) <br />:WOIj <br />ZOOIZ00'd 1h9=! bb�60 ZIOZ/£0/50 <br />