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� <br />PERMIT APPLICATION <br />i BUILDING/MECHANICAL/PLIIMBING/SIGN/SPRINKLER/DEMOLITION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 Cedar St., Everett, WA �J8201 - 425-257-8810 – FAX 425-257-8857 – www.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM "3 ,. ,',� 3�( 2 <br />fornewconstruc6on: Short <br />UILDING PERMIT APPLICATION <br />Use of Building <br />a <br />No._ (attach copy of lo�g <br />�/25 �.3 x/-- <br />a <br />tlescnption) <br />PhonelEmail � ZS–�7S`G^��(�� <br />R PERMIT p�y���� �C � �_ <br />F> <br />U 7 C --7'7�-/.U/. L/ <br />PRICE OF WORK <br />HEAT <br />�sed Use of Buildin <br />9 Gas� EIe�Vic_ O;her <br />ng type: �' Single Family _ Duplex _To�vnhouse _ Multi-Pamiiy _ Commercial <br />of project: _, New _Addition _ Remodel _ Repair _ T.I. _ Sign _Sprinkler_Demolition_Chanc�e of Use <br />�iption of Work �addifional space provided on fhe back): <br />Have you started wot .ing without a permit7 _YES �NO <br />MfCHANICAL PERMIT APPLICATION <br />of Project: _New_Addn <br />SYSTEM <br />PLUMBING PERM17' APPLICATION <br />ofProject: _New_Addn _Alteration_Repair <br />Shmv Number (#1 of /ixtures <br />Medical Gas <br />Other: <br />I herehy certify that I Y�ave read and examined this appliwtion and know tha same to be true and wrrecl NI provis ons of laws and ordinances goveming <br />this type of work will be complied with whether specifed herein or not The granting of a permit does not presume lo give aulMnty to violate or cancel <br />Ihe provision of any oth=r state or lowl law regulating constmction or the pertormance of construction. That I am authorized by the ovmer of this prop^rt� <br />to perto�: e�wrk for wh`ch appjr�tiop is mada and I comply vnth th State ntractors Law 1827 RCW and 296.200 WAC <br />:� <br />.i— ,• 4L /lL � �J' Z— <br />Owner/A� orized Agent Signatur / Date (Revised 22011J <br />�. <br />v <br />