3623 COLBY AVE 2017-01-13 - Laserfiche WebLink

PERMIT APPLICATION BUILDING ! �:��.HANICAL / PLUMBING / SIGN / S_ ! �!!JKLER / 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.gov/permits PROJEGT SITE INFORMATION n �FeT cirF nnnRESS_ . .., PROPERTY TAX #:� ^ � ^ � � �,.. e., ...,.,�+�� „-ri�..• shnrt PlaUsubdivision Lot No. (attach copy of long legai description) BUILDING PERMIT wrr��w� ��n =xistin Use of Building: Contract Price of Work: Pro osed Use of Building: Heat Source: ❑Gas Buiidi�g Type� ❑SFR Detached ❑SFR-Attached �Duplex ❑Multi-Family�F of Units:_ Ty e of Project: ❑New ❑Addition ❑Remodel ❑Repair ❑T.I. ❑Sign ❑Spnnkler DESCRIPTION OF WORK: / l r l�� l�x. �� '�•;� � w 6� � ti't P�' IASSOCIATED BUILDING PERMIT #(if applicable): r5 �`� �� —�� 7 ❑Electric ❑Other_ ❑Commercial ❑Demolition ❑Chan� ❑Industrial of Use ACKNOWLEDGEMENT: 1 have reviewed this application and confirm the information contained herein is true and correct. Work done pursuant to this permrt must compry w�rn current federal, state, and local �aw. rne granting of a permit only authorizes approved work and no deviations therefrom. Deviations must first be authorized in writing from the Building Officia! before being authorized under any cirCumstance. I am the owner, or I am authorized by the owner of this prope�fy to peAorm the work for which application is made, and I comply wrth the State Contrectors Law 18.27 RCW and 296.200A WAC. City of Everett Official Use Onty /i�/l _. �� / �- ?� signature Date PERM # � �}� j (Revised 10/12/2015) �