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ROJECT SITE AC <br />• PERMIT APPLICATION• <br />BUILDING / MECHANICAL / PLUMBING / SIGN / SPRINKLER / DEMOLITION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 982Q1 <br />(P) 425-257-8810 � FAX 425-257-8857 �(E) everetteps@everettwa.gov � wvvw.everettwa.gov/permits <br />"' PROJECT SITE'INFORMATION ;:: ;:: <br />�1�� L��/r ,(� f �ROPERTY TAX <br />r �r �r� <br />�LEGAL for new construction: Short Plat/subdivision Y Lot No. (attach copy of long legal description) � <br />' - BUILDING PERMIT APPLICATION ' _ <br />- <br />: �C�C% �. _ <br />Existing Use of Building: � S Contract Price of Work: $ � <br />Proposed Use of Building: Heat Source: ❑Gas ❑Electric ❑Other <br />Building Type: ��SFR-Detached ❑SFR-Attached ❑Duplex ❑Multi-Family-# of Units: ❑Commercial ❑Industrial <br />Type of Project: ❑New ❑Addition Remodel ❑Repair ❑T,I. ❑Sign ❑Sprinkler ❑Demolition ❑Change of Use <br />DESCRIPTION OF WORK: / ( G+ (`�r� (60 �(' j <br />�..�a 1'> TcZ �� G l fl G�, ��� t�-t-9--�—T�-��lr=� h� �'-� � Y�� c� i/1�1 <br />��.���; r- i.v� 5Gl ����b�rQu� f-����� �� �� ( ��� � <br />� r e� �;c s c�� <br />ASSOCIATED BUILDING PERMIT # (if appiicable): <br />ACKNOWLEDGEMENT.� ! 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 /ocal /aw. The grantrng of a permrt only authorizes approved work and no deviations therefrom. Deviations must first be authorized in writing from the <br />8uilding Officral before being authorized under any circumstance. I am the owner, or 1 am authorized by the owner of this property to perform the work for whrch application is made, <br />and 1 comply wrth the State Contractors Law 18.27 RCW and 296.200A WAC. <br />Ciry of Everett Official Use Only <br />PERMI����� y ��� <br />(Revised 90/12/2015) <br />1'Z <br />