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OB/OL/2012 wEo lZ:a9 raX G?� 487 fi52G Nortcreek Roofing <br />PERMIT APPLICATIO�V <br />�001; 002 <br />3UILDING/MECHANICAL/PLUMBING/SIGNISPRINKLER/DEMOLITION <br />CITY OF EVERETT PERMIT SERVICES �D --�—'—� � <br />3200 Cedar St., Everett, WA 98201 425-257-A810 FAX 425-257-8857 www.everetM�a.org <br />APPLICATIONS ARE ACCEPTED FRCM 8 AM TO 4 PM <br />ennRFSR• _ __ PROPERTVTAXd �ERM�#,�C� _ _.'„�(� <br />for new canstruction: Shod <br />a��3 a� uc <br />� OK9B( _ OW6CYS A9Cf11 <br />(aRach wpy of long legal description) <br />h-5�>-�9n_1 <br />� C0111�2CIOf ,�C00!l2CIOfSAJ201 _TE�ldfl(Imuslpo.idealeA<rolWt+sbcllroT�noawclUCowcMinlPospaco� <br />[i i <br />���—�rt��` �—�c� io <br />�1lc�c.�-� `��5 •'a£33" <br />BUILDING PERMI . APPLICATION CONTRACT PRICE OF wORK <br />fixisling Use of Building _ — <br />Proposed Use o( Building _ �` <br />Building type:�' Sinyle Family _ Duplex _Townhouse _ Multi•Pan�i!y _Commercial <br />Tvoe of oroiecC New Addilion�.,. Remodel Repair T.I. _ Siqn _Sprinkler _[ <br />� <br />m <br />ESCRIPTIONOFWORK/aeditionaispawprovidedonthebacp!: , � <br />`�ea.r- o�Ci .J_ 1 c,.�{ e.r- .1 co m�o�r�-� an C.u'1 d re,�� (��e. 11� �'�'1-� <br />(_c��� �G�S i `� \� �`h . <br />MECHANIC^L. PERMIT APPLICATION <br />ofProJoct: _New_AtlAn _Allcration_Repalr <br />MBING I'ERMIT APPLICATION <br />olProJect: _New_Addn _Alteration_Repair <br />Show Number /a) ol fixtwes _ _ <br />Medical Gas <br />Other: <br />� NumberofHeads � � ulner. I <br />11iereCy ce�i!y I�dt I liave read an0 exam netl Ibis appliCd9e . anE Anow IBe same to �e W P anJ [onecl. A9 provislans o� Nws an� orCindnces �',,oveminq Inis lype ol wcrk wi I Ee G�mFlsd <br />�alli whctlmr spcuL9� hewin Ur not Il�o grant'�ng ol a pertnil aoes nol presume l0 9ive aulitonly lo vioiale or cancel the provrsion o1 any alher slale cr lo W I13vi repulaling wnzln:clion <br />➢ial I am au�honzetl by ihe cnner ol ll�is p�opotly lo pm'onn �ha wo0.lcrwnicn apNi..albn is matle an01 comp!y viilh t�e Slale CONraciors Law 1027 RCIN an � 2902�OA WAC. <br />�5,;.�rz,n �%� 1^n � l�i < < � �,� R - l -1 � <br />OwnodAuthariud A9ont uipnaturo Daie <br />(Revisetl CJ2012) <br />