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PERMIT APPLICATION <br />BUILDING / MECHANICAL I PLUMBING I SiGN I SPRINKLER I DEMOLITION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />(P) 426-257-8810 i FAX 426-257-8867 i (E) everetteps@everettwe,gov I wwvrsverettwa,gov/permits <br />[PROJEGY <br />DRESS: k ilik 643!.IPi®�se) P:if'ibiff��pA� #MFQ1!MII�t1Gili SITE ADj��— iZ0 PROPERTYTAX#: <br />GAL for new construction: Short PlaVsubdlvfsion Lot No._ (attach copy of long legal description) <br />Existing Use of Building: [ Contract Price of Work: $ 1 J <br />Proposed Use of Building; Heat Source: ETGas ElElectrlc ❑Other <br />Building Type: EiSFR Detached EISFR-Attached QDuplex C(Muifi-Famify4 of Units: Commerctai Ellndustrial <br />Type of Projecf: EINew TJAdditlon EIRemodel V Repair ❑T.i. EISign E(Sprinkfer ElDemolition ❑Change of Use <br />DESCRIPTION OF WORK: SAW(PC;s I96tx L-1Ci e n u , ac> & 4owk UN % <br />b��ZJ <br />CIATED BUILDING PERMIT # <br />ii/1��$ �Il!( Chi, t Iil/j1'1' �P1L1��u1� PLUMMKO OWMA't1"APPILiC. VGkd <br />Typa of Project: _New Addn Alteration _.,Repair rn't"..F <br />f Project: __Yew Addn Alterafion "Repair <br /># °f Lfst of Fixtures " °f Llst ofFlxturesist ofFlxtures °f Llst ofFixtures <br />Fixtures Flxttges Fixtures <br />Forced Air Systems <br />Gas Piping <br />Wafer Heater <br />Gas Fireplace <br />Gas Range <br />Clothes Dryer Hookup <br />Range Hood <br />Exhaust Fan <br />Unit Heater <br />Sink & <br />.CKNOWLEDGEMENT,1 ha va revlaived this application and confimr the information confained herein is true and correct Work done pursuant to thls permitmust comply with <br />urgent federal, state, and locallaw. The granting ofa permit only authorizes approved work and no deviations therefrom. Devlafibnsmustflrstbe authorked In writing from the <br />ullding Official before being authorized under any circumstance, !am the owner, or! am authorized by the owner ofthls property to perform the workfor which applicatlon Is made, <br />7d i comply with the State Contractors Law 18.27f and 296.200A WAC, <br />" City of EverettOff/clal Use Only <br />PERMI <br />i� <br />vner/Authorize AgenfSlgnafure Date (Re vlsed6/20/209) <br />