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PERMIT APPLICATION <br />BUILDINGIMECHANICALIPLUMBINGISIGNISPRINKLERIDEMOLITION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 Cedar St., Everett, WA 98201 - 425-257-8810 - FAX 425-257-8857 -www.everett �.org7 v/( <br />APPLICATIGNS ARE ACCEPTED FROM B AM TO 4 PM <br />PROPERTI TA%M PERMIT # <br />ADORESS: �>�% � 'c�J`� c�s�'�f GC�59�n'7ao3oll�� - <br />br new construclion: Sharl <br />M�C-H LRD�saAJ <br />3 2,'�•3 �1 S� S� <br />�i%� IJL � <br />�b•^-'-� l`v1P./N <br />�/R� Lot No. �� (allach copy of long legal descriplion) <br />PhonelE�mail yLs - 3 i 1- �y �� <br />CityiStalelZiO �VF./'�-f-T W� ��Z�'� <br />L 8 I Lic. # S��Nh� F-S�� S �! <br />�F,/ti.W�'. �0��� PhonelEmail –I��-76������ <br />BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK ��, n o <br />HEATSOURCE: <br />Existing Use of Building _ <br />Gas_ Eleclric_ 01her__ <br />Proposed Use of Building <br />Building type: Single Family _ Duplex _Townhouse _ Multi-Family _ Commercial <br />Type of projeci: _. New _ Addition _ Remodel _ Repair _ T.I. _ Sign _Sprinkler _Demolition_Change of Use <br />Descriolion o( Work (atldi(ional spaco provided on the back): <br />you started working without a permil? _YES _NO <br />MECHANICAL PERMIT APPLICATION <br />of ProJect: _New_Addn �Alleration _Repair <br />Show Number (#) ol fixtures <br />i nir' _ �ir nandlinn unils <br />PLUMBING PERMIT APPLICATION <br />of Project: _New_Addn _Alteration_Rapair <br />Medical Gas <br />Other: <br />� P:umber of Heads - - <br />I hereby cen�fy that I have read and examined this application and kno�v Ihe same to he tme and conecl. All provisioi, oI laws anA ordinances 9overning <br />ihis type of vrork �HII be complied xlih �+Mether specified herein or nol The granting af a permit does not presume lo give amhonty lo viclate or cancel <br />the pmvision an other sta�e or Iocai law reguia�ing construclion or �he pedormance of consimctioa That I am authorized by lhe owner of Ihis pmperty <br />�o peAorm e or for which apphcation is made and I comply �Hih the Sta�e Conlractors Law 1827 RCW and 296200 WAC <br />/ <br />,� � lf '� K-�� <br />Owner/ uthorize Agent Signalure <br />Da�e (Revised 712071) <br />