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PERMlT APPLICAT'ION <br />BUILDING/MECHANICALIPLUMBING/SIGNISPRIf�KLERIDEMOLITION <br />CITY OF EVERETT PERMIT SE:RVICES <br />3200 Cedar St., Everett. WA 98201 - 425-257-8810 - FAX �25-957-8857 -owwv.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM fi AM TO 4 PM `� -%`� Z <br />ADDRESS: PROf`ERN TAX !+ PEjih�IT S <br />G'�� 7[7�-c n.,..: �r n,vita •� c;ii^i l•7i'�r'�i � t/i I J L�J, -�ir��i <br />for new construction: Shart <br />� L D �/a� ` <br />7.' � � 7 ��. . <br />� <br />ncTOR • d—h'i <br />���1�� ��T�r <br />No._ (attaU copy of long legal descdplion) <br />j Fhone/E-mail y�� � i � <br />41-- � 2� . �S�- City/StalelZip � l%G2�'!% '�i <br />� f� , " -f �siu�.a� �?�' '1 f�`�( <br />' � i i� �� 4 phonefEm2ii L-L�' <br />.!-Js'. lC [ L'n� i, U8 <br />CONTACT F�R PERMIT �/` `��tN <br />�/ <br />Phnn=/F�mail </Z5'%%5��� <br />BUILDING PERMIT APPLICATION <br />Use of 6uilding <br />PRICE OF WCRK <br />� yl� <br />L(l'/ <br />Proposed Use ot Building_ . i ""-^- ` — —_— <br />B�iiding type: �Single Family _ Duplex_Townhouse Multi-F�mily _ Commercial <br />Typeofproject ,.�j�New _Addition _Remodel Repalr_,T.I._,Sign_Sprinkler_Demolition_Change ofUse <br />DesCriptlonofWork(additionalapaceprovidedontheback): ��/JLqC�- �3L1�'f1.V�, �S �L�2��1���� l�V�l�� <br />,'ve.cc,' G.{� ��/�n;4CG _TT-' S:-I��t�_. LCC�-1Tic �:. � s�:-C' ,vt-'G�.� C.�S <br />/%/��,�c�-- , <br />Have you st�(ted working wiihout a permit7 _YES �NO <br />MECHANICAL PERMIT APPLICrAT10N <br />of Projeet: _New_Addn .�Altcralion_Repair <br />Show NumGer (X) o( lixtures <br />I AIC-airhandlinounits <br />PPRESSION SYSTEM <br />PLUMBING PERMIT APPLICATION <br />ofProject _Nev+_Addn _Alte�ation_Repair <br />Med�cal Gas <br />Other: <br />I hereby cedify that I hav=. read and e�mined this appiication and knrnv the same to be true xnd correct NI pmvisicns et laws and ordinances governing <br />this type of wnrk vrill be complied LN;h whett.er soecified herein or nol The granling of a permit does not presume lo give aulhority to violate v wncel <br />tt.e provision of s,iy other stzte o� Iocai law regulating wnstrudion or tne peAormance of consVuctioa Tha: I am authorized by Ihe ovmer d this pmperty <br />to pedor�Qh� work tor which ��ppi¢jaf�o��{s y�l comply vdth the Stat Contra:,tors L7v 16.27 RCW and 296.20D WAC <br />/—�"� '� Y — `" 7/ <br />Ownc�/Author edAgent5l�nature D �e (Revised7r2071) <br />. . . _.. _. .. . . _. ..._ . _ . . . . � . . � . �. � d <br />