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• PERMII" APPLICATIO� <br />BUILDING / MECHANICAL / PLIJMBING / SIGN / SPF2INKLER / DEMOLITION <br />CITY OF EVERETT PERMIT SERVICES <br />EY 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`INFORMAT:.ION ' <br />PROJECT SITE ADDRES� <br />� oos Pwc� �� � ve <br />LEGAL for new construction: Short Plat/subdivision. <br />PROPERTY TAX #: <br />No. (attach copy of long legal description) <br />` BUILDING PERMIT APPLICATION : � <br />_ , <br />Existing Use of Building: };���e l��Hl h�5 Contract Price of Work: $ 1 G <br />Proposed Use of Building: Y, �,v� �� � % 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 C7Remodel ❑Repair C7T.1. ❑Sign OSprinkler ❑Demolition ❑Change of Use <br />DESCRIPTION OF WORK: � � r po� 1�.� 5���� ��,,S�L�-i or� <br />-7-�,� P � kr �hcl�vc¢ o eK� s�� Kg a',�' '� <br />i Vi a Fa.w V�vYt%1n5 �a it� Gov+�pce4-e, re.w�ot�� ov� eo,F.l✓� -rr1�a('. <br />ASSOCIATED BUILDING PERMIT # (if applicable): <br />_'`�.�s w�l( 1� Yeplott�cd <br />ACKNOWLEDGEMENT.' I have reviewed this application and contirm tne inrormation contained herein is true and correct. Work done pursuant to fhis permrt must compry wirn <br />current federal, state, and local law. The granting of a permit on/y authorizes approved work and no deviations therefrom. Deviations must first be authorized in writing from the <br />Building Official before berng authorized under any circumsfance. 1 am the owner, or 1 am authorized by the owner of this property to perform the work for which application is made, <br />and 1 comply with the State Contractors Law 98.27 RCW and 296.200A WAC. City of Everett Official Use Only <br />Owner/Authorized Agent Si <br />PERMIT # <br />s'IZ"i(p ✓a� <br />Date (Revised i0/12/2015) <br />��� <br />