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�.�_� � <br />�.- <br />��� <br />"��6��iV1`I' ��'�'L.,IC:�il�f� <br />�lJIl..�:)I !�` / illii�Ci-1A�IbC�d�AL I {�'I_lJiifl�4Y�� / �I�Y� / ���If��C�.,.�:� / G_ii��if9OL1'�'iC.��l <br />CITY OF EV[.:RGTT PERMIT SER � <br />3200 CEDAR STREET, EVERETT, � 201 <br />(P) 425-257-8810 � FAX 425-257-8857 �(E) everefteps@everettwa.gov ��mnnv.everetiwa.gov/permifs <br />_ _— _ <br />,-. . . <br />_ BUILDING PERMIT:APPLICATION <br />Existing Use of Building: r R <br />Proposed Use of Building: .SF � <br />Building Type: ❑SFR-Detached <br />Type of Project: ❑New ❑Additio <br />� DESCRIPTION OF' WORK: '�E <br />�Rc:�K �JS'BOt�k'_ f�l T <br />Confract Price of Work: <br />+ OC%> <br />Heat Source: ❑Gas ❑Electric ❑Other <br />❑SFR-Atfached ❑Duplex ❑Multi-Family-# of Units: ❑Commercial ❑]ndustrial <br />n ❑Remodel Repair ❑T.I. ❑Sign ❑Sprinkler ❑Demolition ❑Charge of Use <br />/�A��/L. %JRY �:e7 z' �j�� xt 1., Lrc �sH; 7b c X i��i� �e.//.4-e..eo ��2tx�e�j��: <br />��1�" u�'t�r��ic�`i�wnr � �s�,���'Zw/`fN`D��s ��� <br />(ASSOClATED BUILDING PERMIT # (if applicable): <br />_ , <br />1�LUMB9NG PERMIT.APPLIC�I,TIOId <br />Type of Project: _New Addn _Afteration _Repair <br />Fixtures �-�st of Fixfures Fi � u es List af Fixtures <br />Toilet Backflow Preventer (Inside Bldg) <br />Bafhfub Urinal <br />Lavatory {Wash Basin) Drinking =ountain <br />Shower Floor Drain <br />Kitchen Sink & Disposal Grease Trap <br />Dishwasher RooT Drains <br />Clothes Washer Medical Gas <br />Wafer Heater Other: <br />Sink {Service/Qar/Mop/etc.) Other: <br />ACKNOWLEDGF_MENI:' I have reviewed this app/ication and confirm the information confained herein is t�ue and correct. Work done pursuant to thrs,oerm�t must compry wirn <br />cur�ent federal, state, and local law. 'ihe g�anting of a permit only authonzes approved work and no deviatrons fherefrom. Deviations must first be authonzed rn v✓riting from the <br />L3uilding Offfcial before being auihorized under any circumstance. I am the owner, o�! am authorired by the owner of this property to perform the work �or which applicafion is made, <br />and / comply wifh fhe Sfate Contrartors Law 98.7.7 RCW and ?_9G.7_OOA WAC_ <br />d Ayent Signafure <br />Cify of Evereti Offcial Use Only <br />PERMIT�# <br />�c ( �b �u���,���9 <br />Date (Revised 5/?_0/2096) <br />