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9'�R�1�' ��'�'1�IC��'fOf� <br />�lJIL�.�71� f1��C{-1�,�9LG,�L / C��..11iifl�l�� / SIC����RIY����� / ��ii�C7�,1� i��l <br />CITY OF EVERETT PERMIT SER <br />3200 CEDAR STR�ET, EVERETT, WA 98201 <br />(P) 425-257-8810 � FFlX 425-257-8857 �(E) everetteps@evereftwa.gov � v,rww.everettwa.gov/permits <br />_. . _. - <br />_. , _.BUlLDING PERMIT.APPLI.CATION <br />_xisfing Use of Building: Contract Price of Work: <br />'roposed Use of Building: Heat Source: ❑Gas <br />>uilding Type: �SFR-Detached ❑SFR-Atfached ❑Duplex ❑Multi-Family�# of Units:_ <br />�ype ofi Project: ❑New ❑Addition ❑Remodel [,9Repair ❑T.I. ❑Sign ❑Sprinkler <br />1ESCRIPTION OF WORK: <br />�e � ro� <br />TED BUILDfNG PERMIT # (if <br />❑Electric ❑Other <br />❑Commercial ❑Industrial <br />❑Demolition ❑Chanqe of Use <br />ACKNOWLF_DGEMENT.• I 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 local law. The granting of a permit only authonzes approved v✓ork and no deviations therefrom. Deviafions must first be authonzed in wrifing from the <br />13uilding Ofticial bef ber aufhorired under any r,ircumstance. l am the owner, or l am authorized by the owner of tliis propedy to perform the work for which application is made, <br />and / comply wi the Siat 'onf�actors 1_aw i827 RCW and 296.?_OOA WAC_ <br />Cify of Fveretf Offcial Use Only <br />' �� �7 /�=r� /� P����60�-Oa`� <br />� ' - <br />Owner/A ' ed Agen S� Date (Revised 5/20/2096) <br />