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PERMIT APPLICATION <br />BUILDINGIMECHANICAL/PLUMBINGlSIGN/SPRINKLER/DEMOLITION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 Cedar St ,[veretl, WA 98201 425 257 8810 - FAX 425-257-A857 - www.everettwa org <br />APPLICATIONS ARE ACCEPT[D FHOM R AM TO 4 PM <br />�nDRFSS� n. _ PROPfNIYiA%N PFJ�M1AITN_ � ___ <br />EGAL lor nrw conslruclion Shnn PlaUsubtl.wsion <br />iWNER e 2�yw.,r,�,�cr _ <br />da�ess �,ZS �'j7 P� ,SE <br />ONTRACTOR �� ��JLL,I <br />ddrr.ss <br />ENANT BUSINESS NAME <br />tUILDING PERMIT APPLICATION <br />1 pt Nn I:�uacn copy ol long Icgal acscnpGon) <br />��,o��,t.�,a,� 4� 4 � y/ <br />�rtY,si�i�,z a Fvf,ct r r �- 9�� <br />811�c # <br />Phnne;Fina�l <br />�ONTACT FOR PERMIT <br />'honMLma�l N,�� 3y7 5�Y � <br />:ONTRACT PRICE OF WORK __ ___ _ . _?( <br />Fx sir�G Use of B��.Idiry S� A/ LLf n'� ___ HfAT SOURCC <br />Propused Use o B���ding SFR _ �as__ Eieunc_ r�ner= <br />Budd�ng type _�ingle Fam�ty __ Duple. ,_Townhouse __ MuV�-FamAy _ Commeraal <br />Type ol pro�ect _ New � AddiUon _ Remodel _, Repan _ T I___ Sign __ Spnnkler __ Oemolition_ _. Change ol Usc <br />Descriplion of Work (add�t�ona� s0ace prov�dea on Me Oackl <br />�D�iN�. l�oo�+,, onl jqxto <br />Mavc you slaAcd worFinn without a permil7 �YES _NO <br />MECHANICAL PERMIT APPLICATION <br />Typo of Pro�ocL _Now <br />� _Nle�atlon _Ropalr <br />� ol hrtures <br />an handhng unils <br />i au svstems <br />Gas <br />Ran e � <br />Lxhaust <br />Wwdstove <br />Uue�ir� <br />nl�lAf <br />KLER I SUPPRESSION <br />NumGer of He�As <br />PLUMBING PERMIT APPLICATION <br />ol P�oJect: __New _AAtln _Altoratlan _Repalr <br />Show NumDcrfM) ol fixfurea <br />C�01hC5 w05h@r <br />W0�0f hP71C/ <br />S�nk �service�bar/ <br />Uackn�w preventi <br />Unnal <br />DnnMing Fountain <br />flom dia�n <br />Giease Irap <br />Roal drains <br />Medica� Gas <br />Olher <br />O�her <br />I hereby c.endy Ihal I have �aan m�A e.ammetl this appbcal�on and Fnow tne same la hn Irue and conecl nll piovisions ol izws and oiAlnances govem�ng <br />In�s type ol worF wtll be compiied w�th whelher sDeclfie0 herein or not The g�anling ol d Deimtl Ooes not presume lo give aul�onty lo violale or cancel <br />Ihe piovison 01 any othe� slale or loCal law regulaling ConSWCUon or Ihe peAGrmanCe ol Co�5lrucl�on. Ihei I am aulhonLed by Ihe owner al 1h15 propc�y <br />lo peAorm Ihe work lor which appucalmn �s made ane i comply wnh Ihe SIa1e Contrattors Lew 18 ?7 RCW and Y96 200 WAC <br />e �' I <br />O Aul�on tl A rt Slgnatur� Uale IRev�seA 2,70r rl <br />I <br />'/ � <br />