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������� <br />I�'!� <br />� <br />PEf211i111" APPLICATIO <br />BUILDI[�' MECHANICAL 1 PLUIInBIiVG / SIG PRINKLER / DEMOL1710iV <br />CITY O� EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />(P) 425-257-8810 I FAX 425-257-8857 �(E) everetteps@everettwa.gov � www.everettwa.gov/permits <br />_ <br />BUILDING' PERMIT APPLIGATION <br />';. ; � _ _ <br />Existing Use of Building: Contract Price of Work: <br />Proposed Use of Building: Heat Source: ❑Gas <br />Building Type: ❑SFR-Detached ❑SFR-Attached ❑Duplex ❑Multi-Family-# of Units:_ <br />Type of Project: ❑New C�Addition ❑Remodel C7Repair ❑T.I. �Sign �Sprinkler <br />DESCRIPTION OF WORK: <br />( <br />OElectric ❑Other <br />❑Commercial <br />❑Demolition ❑Chanc <br />��� ����C, �� ��,� ;, ,,,,;,�, ��< <;�"�� ����� ��: � ��,��' �� �� <br />i � � <br />ASSOCIATED BUILDING PERMIT # (if applicable): <br />❑Industrial <br />of Use <br />ACKNOWLEDGEMENT.� I have reviewed this application and confirm fhe information contained herein is true and correct. Work done pursuant to this permit must comply with <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 from the <br />euilding Official before being authorized under any circurnsfance. I am the owner, or I am authorized by the owner of this property to perform the work (or which application is made, <br />and I comply with the State Contractors Law 18.27 RCW and 296.200A WAC. <br />Agent Signature <br />�(- Z� - � � <br />Date <br />City of Everett Off�aal Use Only <br />PERMIT# \� � ' D ( <br />I lU <br />(Revised 10/17J2015) <br />