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From <br />05I91/2012 11:15 �779 P.002I003 <br />S�(0��`� 7 <br />PERMIT Af�PLiCATION <br />BU{LDING/MECHANICAL/PLUMBING/SIGh1/SPRINKLER/DEMOLITION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 Cedar Sl., Everelt, WA 98201 - 425-257-8810 — FAX 425-257-8857 — www.evereihva.org <br />APPLICATIONS ARE ACC[PTED FROM 8 AM TO 4 PM <br />� <br />lor nuw conslrucliort. Shait PC <br />t �rnela l� � <br />�UQ�� �`�� f <br />32 (�ve <br />BUILDIPIG PERMIT APPLICATIO�d <br />Use al 6uilding <br />W � UO��`43�70oc0 �'-i o0 � i1� I� � S-(iif <br />Lol No (liliach mpy W Icng Iegal descnpticn) <br />Phono/Emyl �-aS- a15- `��,- 5 d�7 S <br />CIIY/StatelT.ip �v��e�} � V�1 � ' 1�� �L'.1 <br />�_. L81Lic.p IIC '�A`,�y�lY'�II I`TS�C <br />('I�1GN��ji,WA Vl��y F'honelLmuil 1'��,S��j�0,7v0�- _ <br />ulie <br />CONTf2ACT PRICE OF WORK <br />roposed Use �o/f Building — � — — <br />uilding typa: /� Single Family _ Duplox _Towahouse _ Multi-Family _ Commercial <br />ypeofproject: _Nox� _Addition _Remodel �R^palr_T.L_Sign_Sprinklor_Oemolition_Change ofUse <br />escriplion of WOtk (eAdlflonei space pmvltletl on fhe back) t <br />`��eivlD��l �'�'I Q Ce ��PC-h' � � 1,:. a-}e(- I�-e ci`Ie�r <br />avo you started working without a parmitl _YES _NO <br />MECKANICAL PERMIT APPL(CATION <br />o1ProJec4 _New_AdOn _Atlorallon_Repair <br />Show NumLef (#) ol f/xturus <br />i A/C - air handling urits <br />PRINKLER <br />ON SYSTEM <br />PLUMBING PERMIT APPLICATION <br />af Pro}ecl: _New.__ AJdn <br />Show NumGci (HJ <br />Medical Gas <br />otncr. <br />I nereby cehify thal 1 have read anU uzamined fhls applicatlon artl know Ine samc lo be true antl certocl. All provisions of lav. antl oidlnances governing <br />tl�is type o1 work vnll De complietl vnlh whMher specilied herein or not The granlin8 0/ a permii tloes not p�esume to grve authoiity to viol�le or cancai <br />the provision ol any cther slote or local law regulating wnstruclion or Ihe paYartnance o/ conslructlurt T�at 1 am authorize0 by t�e ovmar ol t�is property <br />to pedorm Ihe wvrk br wfilch aDP���tion Is matlo and I comply w,l� tho State Contractors Law tB27 RCW antl 2562D0 WAC <br />�/ '� ZI IZ <br />�narlAuthodzud Agent gnalurb Date (RCviSeC 7/.'017J <br />