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PERMIT APPLICATION <br />BUILDING/MECHANICAL/PLUMBING/SIGNlSPRINKLERIDEMJOLITION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 Cedar St., Everett, WA 98201 - 425-257-6810 — FAX 425-257-8857 — www.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />TA% H <br /># <br />I ll 0�I- <br />lor new conslniction: Short PlaVsub�ivision Lol No._ (attach copy ol long legal description) <br />C� <br />PERMIT APPLICATION <br />Use of Building <br />_� <br />PRICE OF WORK <br />= b� � <br />HEAT <br />Proposed Use of Building ' —"-- — <br />Building type: ,_ Single Family _ Duplex _Townhouse _ Mulli-Family _ Commercial <br />Type of projec�: _ New _Addilion ,_ Remodel _ Repair _ T.I. _, Sign _Sprinkle� �em�olilion_Ch� e of Use / <br />DescriptionofWork(additionalspaceprovidedonlheback�: �f7�/K7��e �!/f/C�' � 1�•� � �'2 , <br />Have you started workfng without a p��ermit7 _YES _NO <br />MECHANICAL PERMIT APPdICATION <br />Type ol Pro�oct: _New _Addn _Altaration , _ftopair <br />Show Number (p) ol /ixtures _ <br />Gas <br />SPRINKLERISUPP <br />PLUMBING PERMIT APPLICATION <br />ol ProJocl: _Now _Addn _Altention _Repalr <br />ShowNumberfMlo/pxNres __ <br />Medical Gas <br />O�her: <br />I Nuinber oF Heads � """'. <br />I hereby certity Ihat 1 have read and examined ihis applicalion and know Ihe same to be We and correcl. All pmvisions of laws and ordinances goveming <br />Ihis type of work will b= complied �vith a•he�her specified herein or noL 7he granting of a permit does nol presume �o give aulharity to violale or cancel <br />Ihe provisiun ot any olher slate or local law regulating construction or lhe pedormance of consimclion. `hal I am aulhorized 6y ihe owner of Ihis pmperty <br />lo perform !he woB for w' application is made and I comply wilh Ihe Stale Contractors Law 18.27 RC4V and 296200 WAC <br />�.�lll � <br />� �� ��� �� � ���� (Revised2/2011) <br />Own6 Ayt orifd gont Si�gnai�T Da�e <br />`I L <br />