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a <br />PERMIT APPLICATION <br />BUILDINGIMECHANICAL/PLUMBING/SIGN/SPRINKLERIDEMOLITION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 Cedar St., Everett, WA 98201 - 425-257-8810 — FAX 425-257-8857 — www.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />ADDRESS: JPROPERTY TAX _ _ PERMITN <br />for nswconstruction: Short <br />W <br />No.. (attach copy of long legal description) <br />PhonelEmaB <br />Address t-j 2� - 1l''� S i- t u.'�'' VlII L'- W(� ii-..CT n' I <br />♦,TENANT BUSINESS NAME CONTACT FOR PERMIT 1vc-Vgkj;S alb <br />BUILDING PBRMIT APPLICATION (CONTRACT PRICE OF WORK �( <br />Use of Building <br />Proposed Use of Building A <br />Building type: Single Family _ Duplex _Townhouse _ Multi -Family _ Commercial <br />Type of project: _ New _ Addition _ Remodel ,_ Repair _ T.I. _ Sign _Sprinkler _Demolition_Change of Use <br />lescription of Work (additional space provided on the back): <br />Fg1L _i,vLT -Q-xtSii.a De--<-K uMcd fr(I�101� :�V15(e�6lGwYJ LoW�P t^���6 <br />you started working without a permit? _YCS _NO <br />Type of Project: —New _Addn _Alteration _Repair Type of Project: _New _Addn _Alteration _Repair <br />cr....., /al of ffrtums <br />Gas <br />Other: <br />I hereby sanity Brat I have read and examined this application and know the same to be two and correct. All previsions of laws and ordinances goveming <br />this type of work will be complied with whether specified herein or not. The granting of a permit does not presume to give authority to viola's or ccncel <br />the provision of any other state or local law regulating construction or the performance of construction. That I am authorized ty the owner of this property <br />to perform the work for whlc plicallon is made and I comply with the State Contractors Law 18.27 RCW and 296.200 WAC <br />~~ Dale (Revised 212011) <br />Ow Authorized Agent5f ature <br />