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10/1G/2016 FRI 10:01 FAx �25 252 1666 CM xeating <br />� <br />�- <br />�002/p03 <br />p�RMIT APPLICATION <br />BUILDlNG ! MECHANICAL / PLUMBINC3 I SIGN / SPRINKL�R / DEMOLITION <br />CITY OF EVERETT PERMIT S�RVICES <br />3200 CEDAR STREET, EVERETT, WA 9B201 <br />(P) 426-267-9$10 ��AX 425-257-8957 �(�) overeiteps(�everellwa.gov � wwuv,everellwa.go�/pe�mll� <br />g��IQ' 91' Bl�ck' Ink OHI please �ROJe�T SITe tNPO1�MaT1pN � <br />PROJ�CT SlTE ADDFtEss; 'I BOZ CEDAR ST <br />L�GAI. For new conslructlOn; 6hott PlaUsuhtllvisio� <br />PROPERTY TAX #: <br />No. (attach aopy of Iorip legel desarlptlon) <br />BUlI.DING P�RMIT APPLICA�'iON <br />Exietln Us� oF Bulldln ; Contract Prlce of Work: $ 2354.65 <br />Pro osed Uso of 8ulldln � Heat 5ource; Gas ❑Electrlc C70ther <br />Bulldln T e: �]SFR-petaohed C15FR-Attached ❑Du lex ❑Muftl-Famll -# of units: �Commerciel CJlnduslrlal <br />T_ e of Pro ect: C1New OAdaltlon ORemodel ❑Re �ir I�TJ, ❑51 n_dSprinkler QDemolitlon ❑chan�e of Use <br />R�p�,ACE GAS �l�RNACE <br />ASSOCIA7ED BUILDIN(i PERMIT # (If a�plicablel� <br />ACKNOWLEDpEM�NT.� I heva revlewed thls epp!lcelfon and conRrm tha lnlormaNan confalneU nereln is Irue end correct, Work done pwsue�if to fhls permlt musf comply wRh <br />currenf /ederaJ, s1a1a, and fvicel law. 7'he prenling ol a perm/t only eufhorizas approved wo�k entl no tlevla�lony fharefrom, Devletlons must Ilrsr De au�honzed �n wrHing lrom tha <br />Bulk1/np O!rlclaJ baforo baing aulhorized under any c/rcumsfaiice I am fne owner, or ! am aulhwlred by Me ow�ter of Ihla prope�ty to perrorm tlie wurk for whlch eppNcellon Is made. <br />end � compty wkn rhe S1ale Contraclora Law 18,27 RCWand 298.200A WAC. <br />C�ry orEvaretf ofhcisl use onl <br />�'� MIT # <br />b 0 -03� <br />�Revisea s�3rz a <br />