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PERMIT APPLICATION <br />BUILDINGIMECHANICALIPLUMBINGISIGNISPRINKLER/DEMOLITION <br />CITY OF EVERETT PERMIT �ERVICES <br />3200 Cedar St., [verett, WA 98201 - 425-257-8810 — F!„ 425-257-8857 — www everetiwa org 2 3_ r <br />APPLICATIONS ARE ACCEP7ED FROM 9 AM TO 4 PM �' <br />nenarorv rnv u PERMIL� .�/1 n! <br />�ITE ADDRESS: . <br />� `t7ti' I�. ��L t�,eJ�lt �'.i I <br />FGAL lor new eanslmc6ort Shon Pi�Vsu6Arvision____ <br />IWNER k'. �.�.I��.� �,A �r �I�i'.t �A Ii��E y'.�� � <br />ddress .�-�,-/.�. :� �G; j'I if ._ <br />��n,,,.,., i,r1�,(�f� <br />BUILDING PERMIT APPLICATION <br />I.ol No Iallach coDY ol lo�ig iegn� desoiplion� <br />rnonorE-men Q!--��� � J� ���r�( �Ilf�('vl. t'C�,����� � <br />���lhi I . <br />CitylS�a�Nllp f.��•"`ilt� �n�%` ''�'l��P'�' <br />/(��� <br />L & I Lic M <br />PhonelEmail <br />CONTACT FOR PER!AIT <br />miorei[-mad <br />CONTRACTPRICEOfWORK�'-�h_� � ri(;/F�+ <`t���� I�� "1 <br />ExisUng Uee oBuild�ng ______ _..—__-- ------ <br />Proposed Use of Building _ ____ Gxs Eledric Other_ <br />Building rype. % Single Femily _ Duplez __ Townhouse __ Multi-Family _ Commerciel <br />Type of pro�ecL _ New _ Additwn _ Remodei . R�pa�r __ T I___ . S�gn __ Spnnkler _DemolAion_Change of Use <br />Descnptfon of Work (nrld�rronui spare provinr.A on rno t�a: N� <br />r <br />�S� � I�lb_ �,: ���.��. ,`1�� <br />i <br />Have you s1aAeA workinq without a permit7 ___YES _ y�_. NO <br />MECHANICAL PERMIT APPLICATION <br />Type ol Pro�act: _Now _Addn _ Allorntlnn _,Ropalr <br />Show Number (M) ol A.Wres <br />�, AiC _ av handhnn und5 <br />Olher <br />NumhPr nl <br />PLUMBING PERMIT APPLICATION <br />ol ProJocl: _Naw _Addn _Altoretlon _Ropel� <br />Medical Ces <br />O�her <br />I r..��mLy u�bly Ih,tl � havr+ n+ed anA esammetl Ihis afVhcalion end know Ihe sxme lo be Irue and cmracl All provlelons ol lnwe end ordinnnces Ba�emmg <br />I�-. iype ol wor� will be comphed wtlh whether specdieA herem ur nol tha grenUng ol e permlt does nol pmsuma lo give eulhorily to vlolele or cancel <br />r�� piovis�on ol any other slTle or local law regul2ting comiruclion or 1he pedormence ol conslmction Thni l em eulhodteA by Ihe owner ol ihls p�ooerty <br />�, pivlurm tne work loi wh�d� xppl¢ation iy metle end I comply wtlh Ihe S�ale Contrec�Ore �uw 1B 27 RCW BnA 298 200 WAC <br />� �•�-� �_ =��23/ 4-c�ll <br />OwporlAuthorizadAgenlSlgnelure --' Date IPe�rsev7:CCn� <br />