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PERMIT APPLICATION <br />BUILDINGIMECHAMICALIPLUMBINGISIGNlSPRINKLERIaEMOLITION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 Cedar St., Everett, WA 98201 425-257-8810 FAX 425-257-8857 www.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM ��� ��� Z <br />PROPERN TAX N �ERMIT Y <br />Af7ORE5S: �, _IS 1 �l r'l(.. _ /1 i <br />for new conslruc�ion: ShoA Plal/subdivision Lo� No._ (allach copy ol long le9al descriplion) <br />� 7 PhonelE-mell ,' S ��O S' iS Z <br />,� < 6 �J i / �- �� <br />5 F Cityl51ate2ip � 4it-(O'Z <br />j 2�' � Sa.• Fl� I �< J' � <br />ANT:_Owner _OemefsAgent _Conlraclor _Con�ractofsAgent _Tenantlm�,ipm�naooi�7�ro:�o�•,s�rir:ommeoHrer�oe�wor����m�sv�ce� <br />�: �� <br />ILDING PERMIT APPLICATION <br /># <br />Phone/Email <br />FOR PERMIT �� j- yZ2- : <br />�— 1' v� <br />IUa� � Ir�� � . <br />f PRICE OF WORK <br />Existing Use of Building ' 1/ ilJ �i'X HEAT <br />Proposed Use of Building Gas_ Ei� <br />Building lype: _ Single Family _ Duplex �Townhouse _ Multi-Family _ Comr�ercial <br />Type o( project: _ Nev+ _ Addition _ Remodel _ Repair _ T.I. _ Sign _Sprinkler _Demolition <br />DESCRIPTION OF WORK /oddifional>pace providedon the back/: <br />i <br />-; � �; ,: ��l r <br />MECHANICAL PERMIT <br />� <br />oi ProJect: _New _Addn _Allerallon _Repair <br />Show Number /B) o! /ixfures <br />air <br />Heat <br />Bus. Lic. # <br />of <br />� l ) a2. � <br />PLUMBING PERMIT APPLICATION <br />ofProJecc: _Now_Addn _Alteration_Repair <br />ShowNum6cr(N)o//ixtures _ <br />u <br />Other: <br />I hereAy cetlify lhal I have read antl examinetl Ihis app:'.ca:��.on ond knew the same (o be Irue und wrrecl. All provisions ol la�ns and ordinances 9aveming Ihls type ol �vork �nll Ee complietl <br />vniM1 wnelher specRetl herein or noL The graming of a Ferm�l �oes ncl presumo lo give authority to violale or cancel tho pmvis:on ol any other stata or local la�.v regulating wnstrudion <br />Tnat I am authorrzetl by t�e ovmer al l�is p�openy lo Dertorm Iho work for xTich applicatien is mado and I comply wit� tho 51a1e CONraclon Law 1827 RCW antl 256200A V✓AC. <br />�I -�.l � �.��. ' /.,"'c.�c�(�,�; /ft"h ° L"^'lii �����`�-�z <br />Ownndputhorized Agent Si�naturo <br />J ���e (Revised62072) <br />