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� PERMIT APPLICATION <br />BUILDINGTMECHANICAL / PLUMBING / SIGN / INKLER / DEMOLITION <br />CITY OF EVERETT PERMIT SERVICES <br />E 3200 CEDAR STREET, EVERETT, WA 98201 <br />(P) 425-257-8810 � FAX 425-257-8857 �(E) everetteps@everettwa.gov � www.everettwa.gov/permits <br />PROJECT SITE INFORMATION <br />'"�CT SITE ADDRESS: _ PRnPFRTY TAX #: <br />LEGAL for new construction: Short PlaUsubdivi <br />�-}v�i'-ic1�C�<_�'sl�<` � t�=J <br />No. (attach copy of long legal description) <br />BUILDING PERMIT APPLICATION <br />Existing Use of Building: C'/-} o� i Contract Price of Work: $ r`i u <br />Proposed Use of Building� (�j�(1f'�=�C�-� 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 />L.� �..;z�,}'::� r"�X� ��v��F� �'��''�'e=i �,N"i t3 �1v+v-� �y� �"�i�'-N�-��A_1G- 1,..1 �U,�l�._S, ��.�.S�Y�u- i.—'l�' C�Y�.�-i+�(I-�— <br />CI <br />�-�"C's � . �� 1-�;-�T }�-�; Gy�- -� �� ;' l,rl� � `7Y d� , .-� i3 � � ' � U '.�1= vin •� l� :l- �1.5 <br />IASSOCIATED BUILDING PERMIT # (if applicable): _ <br />ACKNOWLEDGEMENT: I have reviewed this application and confirm the information contained herein is true and correct. Work done pu�suant to this permit must compry wirn <br />current federal, state, and local law. The granting of a permit only authorizes approved work and no deviations therefrom. Deviations must first be authorized in writing from the <br />Building Official before being authorized under any circumstance. 1 am the owner, or I am authorized by the owner of this property to perform the work for which application is made, <br />and / complv with the State Contractors Law 18.27 RCW and 296.200A WAC. <br />�-�'! _ <br />�, <br />Agent Signature <br />City of Everett Official Use Only <br />PERMIT # �� <br />�, � � �..� i � C l �a <br />(Revised 10/12/2015) <br />1fZ <br />