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0 PERMIT APPLICATION • <br />BUILDING / MECHANICAL / PLUMBING / SIGN / SPRINKLER / DEMOLITION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />(P) 425-257-8810 1 FAX 425-257-8857 1 (E) everetteps@everettwa.gov I www.evereftwa.gov/permits <br />(Blue.or Black Ink Only Please) PROJECT SITE -INFORMATION <br />PROJECT SITE ADDRESS: 1412 HOYT AVE, EVERETT WA 98201 PROPERTY TAX #: 00438529402600 <br />LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) SEE ATTACHED <br />BUILDING PERMIT APPLICATION 0 <br />Existing Use of Building: N/A Contract Price of Work <br />Proposed Use of Building: SINGLE FAMILY Heat Source: ❑Gas ®Electric []Other <br />Building Type: DISFR-Detached ❑SFR-Attached ❑Duplex []Multi -Family-# of Units: ❑Commercial ❑Industrial <br />Type of Project: ®New ❑Addition ❑Remodel ❑Repair ❑T.I. ❑Sin ❑S rinkler ❑Demolition ❑Change of Use <br />DESCRIPTION OF WORK: <br />NEW CUSTOM MODULAR HOME DELIVERED AS FIVE MODULES TO REST ON TRADITIONAL CONCRETE <br />FOUNDATION. SITE -RELATED WORK INCLUDES COMPLETION OF ROOF, PORCHES, <br />ASSOCIATED BUILDING PERMIT # (if applicable): <br />ACKNOWLEDGEMENT., I have reviewed this application and confirm the information contained herein is true and correct. Work done pursuant to this permit must comply with <br />current federal, state, and local law. The granting of a permit only authorizes approved work and no deviations therefrom. Deviations must first be authorized in writing from the <br />Building Official before being authorized under any circumstance. I am the owner, or l am authorized by the owner of this property to perform the work for which application is made, <br />and I comply with the State Contractors Law 18.27 RCW and 296.200A WAC. <br />City of Everett Official Use Only <br />M#<6 <br />Ow <br />(Revised 912312016) <br />