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PERMI�' APPLICATION <br />BUILDINGIMECHANICAL/PLUMBING/SIGN/SPRINKLER/DEMOLITION <br />CITY OF EVERETf PERMIT SERVICES <br />3200 Cedar St., Everett, WA 98201 - 425-257-8810 - FAX 425-257-8857 - www.evereltwaG.o`� <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM I <br />ADDRESS: r �'.'-�+'E T � Lv� PROPERN TAX N PERj.7�T # <br />lii/l �I r�� /� �'� SE `i��.�.:,r vo,�b Uo 00 /bU C� � <br />(ar new eonslrur,tion: ShoA Platlsubtlivision <br />�l �� / /� d r <br />r�A(.%�f <br />lLDING PERMIT APPLICATIOPI <br />Lot No._ (a�tach copy ol <br />io�e,e.man�.�5-�?3`i -36Ls <br />� )� <br />iy/StatelZip LI�C?�C-'7r l <br />g � �.�� � <br />Phone/Email a�� <br />ONTACT FOR PERMIT `✓c. � <br />�> �3 % 3E65 <br />ionelE-mail fG)S�i(�/1'7C�� ic <br />ONTRACT PRICE OF WORK _ <br />le9o� descnption) <br />`�,s �v n����,< -�(eor.�o E✓ <br />? 1��1 v% <-=f.�' <br />•(-� I 1�� I J I <br />I�c: ��I/c;-�r; <br />�/oo.-nl (�' �i/Y]l-i'� �c�M <br />Existing Use of Building f/" �5��� �' �'�'I ��i�t� � 1 �"^/"` ��� r�{ � nen i awn�=. <br />Proposed Use of Building /� � � �t (��� � ��- � �c�� �� ��'•' �� �����'� Gas Elecuic o eih r_ <br />Buitding type: J_ Single Family _ Duple>x —Townhouse _ Multi-Family _ Commercial <br />Type of projecC ._ New _ Addition I! Remodel _ Repair _ T.I. _ Sign _Sprinkler _Demolition_Change of Use <br />)!, c -= <br />Descriplion oF Work (atldi�ional spac� provided on the back) :� �,� �� � �� �/X i�-� ��� � �j�' � V� "`� S � <br />� i/ <br />�n-�� � �7cc�lr0U��1-�5, ,.�r I_7;;-!l�;��,iv, <br />Have you sWrted working without a permil7 _YES = 0 <br />MECHANiCAL PERMIT AFPLICATION PLUMBING PERMIT APPLiCATIOPI <br />of ProJecC _New ��Addn '_Altcration _Repalr <br />Show Numbcr (tl) ol /i.rturcs <br />I AIC-airhandlinaunit5 <br />u <br />u <br />heater <br />d <br />ofProJech _Nmv ` Addo _Alleration_Repalr <br />Show Number (N) ol (iutures <br />P,Aedical Gas <br />Olher: <br />I NumberofHeads � """'. <br />I hereby certity Ihat I have reatl antl examinetl Riis appl¢ation and know �he same �o Ue iruc and correct. All provisions o laws and ordinances goveming <br />Inu �ypc nl work will be complied wllh whether specilietl herem or noL The granting o/ a permit does nol presume lo �ive authority to violate or cancel <br />ihe pmvision ol any o�her slale or local law regWaling consimction or the peAormance of conslruclioa Thal I am au�horized by Ihe owner ol this properry <br />�o perform the vmrk for vrhich applicalion is mad and I comply wi�h the Stale Con�racturs Law 7827 RCW antl 296200 WAC <br />_—� '-,/'� ,� �,.,-_ %�/� ii. <br />�//�� > �' �' <br />OnnerlAuthodzed AgeA[ Signaturc Date (Revised 2/2011) <br />I/� <br />