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S1TE ADDRESS: <br />t'�RN11T: i-�PPL.ICA71OR1 <br />�111L.�1�/ MEGHANIC�4L / �LUllf(BliVC71 SIG�PRI�G�C�.�R ( D�i�iOLll'ION <br />CITY OF EVERETT PERMIT SERVI <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />(P) 425-257-8810 � FAX 425-257-8857 �(E) everetteps@everettwa.gov j www.everetfwa.gov/permits <br />.:.: ..:. :...... .. ..::......::-_,,...;:..: ..-:.,.... ..:- --..:...:. . _::,,.._.:.:.._.�.;...:..,.....::_ :,.:i.-.::� :;:�;:.;-_:: ;.:_:; :; :<:;-;<::=":;:: ::=:::':' '•. i �_ : , _ ...� <br />_ � .: .:::,' -.�..,�. <br />".,:�:�•.':::.' -��O��.r'.�_�,�-r�. r�i�o�z�vi�►-r�Q� . :_ .. . ;. .... . ._ . . <br />, ..: ::..::....._.:. :. <br />PROPER7Y TAX #; <br />for new construction: Short Plat/subdivision Lot No. (affach copy of long legal description) <br />ng Use of Buiiding: <br />�sed Use ofi Building: <br />ng Type: ❑SFR-Qetached <br />of Project: CINew L�Add <br />,1�����c�✓� <br />C1SFR-Attached ❑ <br />� �R�model I�Ri <br />/�1 s �Tf¢L- � <br />OGIATED BUILDING PERMIT # (if <br />Contract Price of Work: <br />Heat 5ource: C1Gas <br />❑Muiti-Family-# of Units:_ <br />pT,I, pSign �Sprinkler <br />❑Electric ❑Other <br />C1Commereial Cllndustrial <br />GlPemoiitian ❑Change of Use <br />ACKNOWLEDGEMENT.• ! have reviewed this application and Confirm the information contained herein is true and correct. Work done pursuanf fo this permit must comp�y wirn <br />a�rrent federal, state, and locallaw. The granting of a permit only aufhorizes approved work and no deviations therefrom. Devrations must firsf be authorized in writing from the <br />Buildrng D�cial Gefore being authorized under any circumsfance. I am the owner, or I am authorized ky the owner of this property fo perfo�m fhe wo�k for which application is made, <br />and 1 comply with the Stafe Contractors Law 98.27 RCIN and 296.2o0A WAC. City of F_verett Official Use Only <br />Agent S <br />uate <br />PERMIT # � ; �-;; <br />;; ' � ^ �', <br />(Revised i0/92/2015) y <br />