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� PERMIT APPLICATION� <br />BUILDING / MECHANICAL / PLUMBING / SIGN / SPRINKLER / DEMOLITION <br />CITY OF EVERETT PERMIT SERVICES <br />EV 3200 CEDAR STREET, EVERETT, WA 98201 <br />(P) 425-257-8810 I FAX 425-257-8857 I(E) everetteps@_everettwa.gov � www.everettwa.gov/permits <br />6UILDING PCKm� � wrr���.w� �vry <br />i <br />� T� <br />Existing Use of Building: Contract Price of Work: $ i ��� . <br />Proposed Use of Building: Heat Source: ❑Gas ❑Electric ❑Other <br />Building Type: ❑SFR-Detached ❑SFR-Attached ❑Duplex ❑Multi-Family-# of Units: ❑Commercial ❑Industrial <br />Type of Project ❑New ❑Addition ❑Remodel ❑Repair ❑T I. ❑Sign ❑Sprinkler ❑Demolition ❑Change of Use <br />DESCRIPTION OF WORK: <br />K.� �' L----\ 1'� "� �� � i� �'�r 1 � l {` <br />� -- , � IZ �, ,, �� V.. �? 1 <br />. i�',� �,-y.�,`�(,`-- n p �,�- \ ;-� � '� . 1 S r <br />ASSOCIATED BUILDING PERMIT # (if applicable). � ` �� <br />ACKNOWLEDGEMENT: I have reviewed this application and confirm the information contained herein is true and correct. Work done pursuant to this permit must comply with <br />current federal, state, and local law. The granting of a permit only authorizes approved work and no deviations therefrom. Deviations must lirst be authorized in writing f�orn the <br />Building Official before being authorized under any circumstance. 1 am the owner, or 1 am authorized by the owner of this property to perform the work for which application is made, <br />and 1 r.� I�i the State Contractors Law 18.27 RCW and 296.200A WAC. <br />uthorized Agent <br />I-'I�'ILr <br />�ate <br />City of Everett Official Use Only <br />PERMIT # <br />I, �� � � . <br />(Revised 10/12/2015) <br />��,, ',�'� % <br />� <br />r <br />