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PERMIT APPLICATION <br />BUIL�INGIMECIiANICAL/PLUMBINGISIGN/SPRINKLER/DEMOLITION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 Cedar St., Everei�, WA 98201 - 425-257-8810 — FAX 425-257-8857 — www.ev sa.org./�Q Z 7 <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM /J%��G'l/ � <br />ADDREiS' �l �. � PROPEHTY A p _ <br />.�'n�'� (��; �1,;.,,.,,:� r,��(' �- ��^�i 00 �00 a <br />lor new construclion: Short P <br />l ' _ i"� �..� % (r..'. C-- <br />(t SC��3 N/F�h-���t:�'I lWE' ` <br />�croR �l� ,( /t1A�:,�ra-i /�-(S� <br />�' i <br />; "f �r /''` � / -�r /;;1;,:; � , <br />--� fr. 'r I�� 1�1 { r� �,� 1 i . <br />,� r <br />ILDING PERMIT APPLICATION <br />f <br />t!.�L81Lic.# <br />��?t <br />(attach capy ol lon�-legal descriplion) <br />ZU� <br />t/ l, N'1 fJT C'1 <br />�Phone/Email �z�- 41 Y- 0?`� � <br />OR PERMIT �J�v� �,L1 O�'1 S G'✓� <br />f� <br />�'LS^' � � � - C? S' `-t �l <br />PRICE OF WORK <br />Existing Use of Building �1 ` -� � � ` ��� 1 ' ! /-�r,�t� ->o.� v�� , � � ���• •�� <br />I � Gas ` Electricy� Olher_ <br />Proposed Use of Building_ � f��+ -� — <br />Building type: _ Single Family _ Duplex _Townhouse _ Multi-Family �ommercial <br />Type of project: _ New 'y�j�Addition I� Remodel _ Repair _ T.I. _ Sign _Sprinkler _Demolition,_Change oi Use <br />Descriplion o( Work (adCdional space provided on (he back): <br />Have you started workfng without a permit7 _YES �NO <br />MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br />oi ProJoct: _New �! Addn <br />SPRINKIER I <br />oflieads <br />_Repalr <br />�u <br />o1Pro�ect: _New_Addn _Alteretlon_Repalr <br />Show Numbcr (N) ol (lxtures <br />Medical Gas <br />Other: <br />Other: <br />I hemby certify Ihat I have read and examined Ihis application and knaw ihe same lo be Irue and conecl. All provisions of laws and ordinances goveming <br />this type ol �vork will be complied with whelher sprcified herein or noL The grenting ol a pertnit tloes nol presume Io give aulhority to violale or cantel <br />the provision of Iher state or local law regulating consWclion or lhe peAormance ol consWction. Thal I am authorized hy the owner ol this pmpeAy <br />to pertorm wor or which application is made and I comply with Ihe State Contractors La�v 1027 RCW and 296200 WAC <br />' c�,� V"�,% - lb' 1� <br />Ownod Uth ¢cAAgenlSlgnatum Daie (Revised2/2017) <br />