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PERMIT APPLICATION <br />BUILDING(MECHANICAL/PLUMBING/SIGN/SPRINKLERIDEMOLITION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 Cedar St, Everett, WA 98201 - 425-257-8810 — FAX 425-257.8857 — WNw evere ti `� a _/ <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM ^'nxx <br />(attach copy of long legal description) <br />for new constructon Short <br />I T r0.4+ r'YI CdyrstateMp eu u.� <br />I Lic.A ti/4^ NCH/' <br />FORpPERMIT lfa.f' a <br />11 broU-: <br />BUILDING PERMIT APPLICATION ICONTRACTPRICE OFWORK <br />Use of Building <br />Proposed Use of Building <br />Building type �/Single Family _ Duplex —Townhouse _Multifamily _Commercial <br />Change of Use <br />Type of project 4L New _ Addition _ Remodel _ Repair _ T.I. ,_, Sign _Sprinkler _Demolition_ <br />Description of Work (additional space p ovided the back). <br />r,e, <br />you started working without a permit? _YES /`NO _ <br />MECHANICAL PERMIT APPLICATION <br />PLUTABING PERMIT APPLICATION <br />ul pro)c<r N,•w _Ands - _Alteration _Repair Type of Project! _New_Addn _Alteration _Repair <br />Show Number (a) of fixtures <br />Show Number (a) of fixtures Toilet -- <br />a,r _ w,r handhna units ., <br />lam <br />Other <br />Gas <br />andy that I have read and examined this appl,Calicn and knew the same to be true and cared All provisions of laws and ordinances governing <br />I hereby coak will 6e canpl,ed with whether specified herc�r or not The granting of a permit does not presume to give authority to violate or cancel <br />this type arhe <br />the to pedor'mhof any e wank for other <br />state or local <br />la s made and I comply witIon h the a Slate ConVac o... Law B 27 CWalalnd 298 2001 WACy t� per or this progeny <br />) ��„� 2l 1a-' V/3 (Revised NOrf) <br />OwnerlAuthori Agent Signature <br />Date <br />