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PERMIT APPLICATIO <br />BUILDIN�IVIECHANICAL / PLUMBING / SIGI�PRINKLER / DEMOLITION <br />� CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />(P) 425-257-8810 � FAX 425-257-8857 �(E) everetteps@everettwa.gov � www.everettwa.gov/permits <br />- � PROJECT SITE INFORMATION <br />PROJECT SITE ADDRESS: 34,1 O O�kGS AV2 PROPERTY TAX #: <br />ILEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) I <br />BUILDING PERMIT APPLICATION <br />sting Use of Building: SFR <br />�posed Use of Building: SFR <br />Iding Type: OSFR-Detached ❑SFR-Attached <br />�e of Project: ❑New ❑Addition mRemodel <br />SCRIPTION OF WORK: <br />TED BUILDING PERMIT # (if applicablel: <br />Contract Price of Work: $ <br />�Heat Source: �Gas �Electric ❑Other <br />❑Duplex ❑Multi-Family-# of Units: ❑Commercial ❑Industrial <br />❑Repair ❑T.I. ❑Sign ❑Sprinkler ❑Demolition ❑Change of Use <br />O (/V �/• 1 U�J ��� , �+�1 ' <br />� � <br />C.,v�-v�af ��� <br />ACKNOWLEDGEMENT: I have reviewed this application and confirm the information contained herein is true and co�rect. Work done pursuant to this permit must comply wifh <br />current federal, state, and local law. The granting of a permit only authorizes approved work and no deviations therefrorn. Deviations must first be authorized in writing from the <br />Bui/drng 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 />�� 3"' � City of Everett Official Use Only <br />i' � /� � � PERMIT # _ <br />' '� <br />f/ �[%/ � ( � -�' _ �� ; �? <br />Owner/AutKorized Ag�4 Signatur Date � (Revised 10/12/2015) � <br />