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10/3�/2013 10:11 42558286� TH= DANIKA CO�hPANY PAGE 04/07 <br />• <br />PERMIT APPLICATION <br />BUILDING/MECHANICAL/PLUMBING/SIGN/SPRINKLER/DEMOLITION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 Cedar St., Everett, WA 98201 - 425-257-8810 — FAX 425-257-8857 — wvnv.everettwa.org <br />APPLICATInNS �RE ACCEPTED FROM 8 Afd TO 4 PM ,� �O ��� <br />iITEADDj�,$S�3fd St EVERETT PROPERTYTAXp p ^ y, <br />>tl't7 . J V�R1�� 1 /1 — !'S-1t J_ �. <br />ior ne�.v consirucuon�. Shon <br />� Todd Pollack <br />806 33rd St <br />uaniKa rlumbina R <br />3b14 73rd Dr NE. M <br />BUILDING PERMIT APPLICATION <br />No � (atla[h copy ollong Icgal tloscrip6on) <br />ano���e.m��i 425-2; <br />cnYisi�i�iz�P EVERETT <br />�9 I� 8 � L�a N <br />WA 98270 <br />335-351 <br />Todd Pollack <br />� <br />PRICE OF WORK _ $SOO OO <br />txistinc� Use of Building <br />HEATSOURCE: <br />Proposed Use of Building <br />Gas Electnc Olhe <br />Build�ng type: Z(_ Sngle Family _ Duplox _Townhouse _ Mulli�Family _ �ummercial <br />Type of projecC Now _ qddi6on Romodel _ Repair x T.I. _ Sign _Sprinkler Uemolilion Change of Use <br />�e5ciipliOn p1 WOrk (addifioral space piovitleU on Ihe Datk): <br />Have you started working without a permit? �(_YES _NO <br />MECHANICAL PERMIT APPLICATION <br />ol Pwject ,_Now _q�dn _qltcration _Ropair <br />Un <br />SP <br />— air <br />ol <br />units <br />ION <br />PLUMBING PERMIT APPLICATION <br />ol Plojnct: _Nnw _Addn _Altumtion _�Repair <br />i1 <br />smk <br />' unnninq 1 aunlEnn <br />� Floor tlrmn <br />_ Grease �np <br />Rno( drains <br />� Medical Gas <br />I O!hcr. <br />Olher: <br />I heieby cerhly thal I have reatl anA exanuned Ilas apGlicabon anU V.nor� the ;ame tu Co Irue and correcl NI pipvisions of I;i•.vs anA ortlmnncps govrm�nq <br />�his lype 01 work will bc comp6CU viilh whcihm spcup�W hermn or no�. Thc gr�n�iny ol a pcimit UGes nGl pfCSumn �p �iyC Buihonly 10 violate or ;an��l <br />Ihe pwvision ol any olher slaln or tow; law rogulahnq cunclrucli�n nr Ihe pPrlormarce M con;lrucbon Thal I�im ;wlLonznA hy Uir ovmw o! Ihis pmpnny <br />tu pedorm �h� work lor which ipplic:�liun 15 maUe and I comply vnU� Uu; ;�,;�� ConVar.to�; Lav� If! �7 f�CVJ nnd'19G 20D WAC <br />\l�� <br />(ltmiq.e�1 ?/:Ot I) <br />OWnIdAU�horiZod Agont Sign�turc Uaic <br />com <br />