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PERMIT APPLICATIOfV <br />BUILDIN�MECHANICAL / PLUMBING / SIGN /�RINKLER / 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 />, <br />- PROJECT SITE INFORMATI:ON - <br />PROJECT SI _E ADp RESS: PROPERTY TAX #: � <br />r �.Z v{ i � s� i�. S.s -- <br />�LEGAL for new construction: Short PlaUsubdivision Lot No. (attach copy of �ong legal description) <br />_ <br />__ <br />' BUILDING`PERMIT APPLICATION. <br />Existing Use of Building: �� Contract Price of Work: $ <br />Proposed Use of Building: ,�; � Heat Source: ❑Gas ❑Electric OOther <br />Building Type: FR-Detached FR-Attached ❑Duplex ❑Multi-Family-# of Units: ❑Commercial ❑Industrial <br />Type of Project: ❑New ❑Addition ❑Remodef ORepair L7T.1. ❑Sign �Sprinkler Demolition ❑Change of Use <br />DESCRIPTION OF WORK: <br />��2 �vtLJ V�Yi%��� <br />TED BUILDING PERMIT # (if appli <br />� J� <br />�E <br />C�u %l L L �"�- �,� �. j v ,a : ��.. �i��l� C�6" <br />%1�. ��� /�`����� <br />PLU'MBING P.E:RMIT:I <br />Type of Project: _New _Addn <br /># of Lisf of Fixtures # of <br />Fixtures Fixtures <br />Shower <br />Kitchen Sink & C <br />Dishwasher <br />Clothes Washer <br />Water Heater <br />PPLICATION <br />_Alteration _Repair <br />List of Fixtures <br />Backflow Preventer (Inside <br />Urinal <br />Drinking Fountain <br />Floor Drain <br />Grease Trap <br />Roof Drains <br />Medical Gas <br />ACKNOWLEDGEMENT.• 1 have reviewed this application and confirm the information contained herein is true and correct. Work done pursuant ro tnis perm�r musr cornpry w�u� <br />current federal, state, and loca/ law. The granting of a permit only authorizes approved work and no deviafions therefrom. Deviations must first be authorized in writing from the <br />Building Official before being authorized under any circumstance. I am the owner, or ! am authorized by the owner of this property to perform the woik for which application is made, <br />and I comp/y with the State Confractors Law_18.2TRCl�nd 296.200A WAC. <br />City of Everett Official Use On/y <br />PE IT # <br />- S�� .3// c � � �0'i�j � �j� <br />Ow ktiorized Agent Signature Date (Revise 10/1u�u�5) <br />