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p�1�Nili APPLIC,�ilO <br />�UIL.DIN�ViECHANMCAL / PLIJNi�IMG / SIG PRIMKLIER / DEfViOL.ITION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />(P) 425-257-8810 � FAX 425-257-8857 �(E) everetteps@everetiwa.gov � www.everettwa.gov/permits <br />_. . _ , _ <br />; ; _ PRo�Ecr ���� �r��oRn��a-rior� <br />_. _ _ _ - _ <br />PROJECT SITE ADDRESS: -� �� ,_„ , r-. � PROPERTY TAX #: <br />�LEGAL for new construction: 5hort Plat/subdivision Lot No. (attach copy of long legaf description) � <br />_, : ,_ -: <br />; ` ` BUILDING PERMIT <br />Exisfing Use of Building: Contract Price of Work: : <br />Proposed Use of Build� Heat Source: ❑Gas <br />Building Type: FR-Detached ❑SFR-Attached ❑D ex ❑Multi-Family-# of Units:_ <br />Type of Project: ❑New ❑Addifion ❑Remodel epair ❑T.I. ❑Sign ❑Sprinkler <br />DESCRIPTION OF WORK: 1 <br />i � t� c�� t-�� 5t'�v, �-�- �i��� ,�h�l- o�' <br />OCIATED BUILDING PERMIT # (if <br />❑Electric ❑Other <br />❑Commercial ❑Indusfrial <br />❑Demolition ❑Change of Use <br />�� ���� <br />ACKNOINLEDGEMENT: 1 have reviewed fhis application and confirm the information contained l�erein is true and correct. Worlt done pursuanf to fhis permit must comply wifh <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 frorn the <br />Building Official before being authorized under any circumstance. I am the owner, or I am authonzed by the owner of this property to perform the work fo� which application is made, <br />and l comply with the State Contractors Law 18.27 RCW and 296.200A WAC. <br />OI <br />Cify of Everett Off�cial Use n y <br />PERMIT �lI ; ( <br />� 1 lL J� � �% �--j" <br />(Revised 10/12/2095) <br />