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PERMIT APPLICATIOfV <br />BUILDING/MECHANICAL/PLUMBIIVG/51GNISPRINKLERlDEMOLITIOIv <br />CITY OF EVERETT PE:'.MIT SERVICES <br />3200 Cec'ar St., Ee�erett, WA 98201 - 425-257-8810 — FA)( 425-257-8857 —ww�v.everettwa.org <br />APPLICATIONS ARE ACCF.PTE� FROM 8 AM TO 4 PM _ S-�,5 -/ <br />` �S I`1 ��1.�� t <br />lor ne:i consWclion: Short Pla�lsubdivision _Lot IJo._ (a�tach copy ol long Iegal descrip�ien) <br />� 1n5 CY �. �\KP_ <br />tim Q- <br />70R �`��� Co��S�"�.t�:��- .�r.0 IL&ILic.# <br />1� �J M<.�'.\y., A.,e ��c�e� � `��e2o`� <br />BUILDING PERMIT P.R:'LICATIO�I <br />Use of Buiiding <br />��L}' S5� L.-If/� <br />�TYISC'�U11p1G <br />PhenelEma�l ��2� -S�}_ � <br />OR PERMIT ;��� O�vt S <br />yZ5 -5�1 -95 5 � <br />PRICE OF WORK �"�'a <br />�� <br />>sed Use of Builaing i — — — <br />ngtype: _SingleFamily _Duplex_Townhouse _MWti-Famiiy _Commercial <br />ofprojecC _New _Addition _Remodel _Repair_T.I._Sign_Sprini:ler_Demolition_Change otUse <br />ription o( Wofk (addilionul space pmvided on Ihe back) : <br />AJ� SMu�: -b V�..,:.�� J��c� c),sF.�.,�.sM� � ncw v..1.,e �n {•�,��, k��'rl�c•. 5.-.k <br />¢ti,r�-�, �.�,�� . / <br />you started working without a permit7 _YES V-NO _ <br />MECHANICAL PERMIT APPLICATION <br />ofProject:_New_Atldn � AlteraUon_Repair <br />SPRINKLER I SUPPRESSION <br />PLUMBING PERMIT APPLICATION <br />of ProJect: _New_Addn � Alteration _Repalr <br />Sl�ow Number!#) allizfures <br />fvledical 3as <br />Other: <br />I hereby certify that I havo read and examined Ihi, applica�ion and knmv the sarne to be irue and correcL NI F'ovisions ol la�vs and ordinances goveming <br />this rype of work will Ue complietl �vith �shether specifed hemin or not. The gran�ing ol a permit dees ncl presume to give aWhority fo violate or cancel <br />ihe pmvision ot any other state or local law re9ulaling consiruclion or Ihe pertermance ol construction. That I am authonzed by the owner of this property <br />�o perfor lhe w r for v.hich application is mzde and I compty with Ihe State Contractors Law 1817 RCW and 296200 WAC <br />=.y�� S-��� � z. <br />Ovmed t' r zed Agent Signature oale (Revised 712011) <br />