1030 99TH ST SW 2016-10-25 - Laserfiche WebLink

� PERMIT APPLICATIOf� BUILDING / MECHANICAL / PLUMBIN G / SIGN / SPRINKLER / DEMOLITION CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET, EVERETT, WA 98201 (P) 425-257-8810 � FAX 425-257-8857 �(E) everetteps@everettwa.gov � www.everettwa.govlpermits PROJECT SITE INFORMATION �JECT SITE ADDRESS: �� g9 S r S� PROPERTY TAX #: �� O� /$ DO00 33 pp iAL for new construction: Short Piat/subdivision Lot No. (attach copy of long legal description) l BUILDING PERMIT APPLICATION xistin Use of Buildin : Contract Price of Work: 5 roposed Use of Buildin : Heat Source: ❑Gas ❑Electric ❑Other uilding Type: ❑SFR-Detached ❑SFR-Attached ❑Duplex ❑MuIG-Family-# of Units� ❑Commercial ❑Industrial �pe of Project: ❑New ❑Addition ❑Remodel ❑Repair OT I ❑SI n ❑Sprinkler ❑Demolition ❑Chan e of Use ESCRIPTION OF WORK: i . � � �-t,�"�e�'��'�i�hJ � SSOCIATED BUILDING PERMIT # ('rf applicable): ACKNOWLEDGEMENT.• I heve reviewed this application and confrrm the in(ormation contained herein is true and correct. Work done pursuant !o thrs pe�nit must comply with current federal, state, and loca! law_ The granting of a permrt only euthorizes approved work and no deviafions therefrom. Deviations must first be authorized in writing from the Burlding O�clal before being authorized under any circumstance. 1 am the owner, or 1 am authorized by the owner of thrs property to perform the worfc for which application is made, and I comply v�ith the State Contractors Law 18.27 RCW and 296.200A WAC. City of Everett O�cial Use ONy PERMIT # �,�,a�� Oz/ay��o,� �2— re Date (Revised 10/12/2015)