Laserfiche WebLink
PERMIT APPLICe4TION <br />BUILDI�/ MECHANICAL / PLUIU1BIfVG / SIG�PRIIVKLER / DEMOLITION <br />CITY OF EVERETT PERMIT SERVIC S <br />� 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 INFORMAT.I:ON ` <br />_ __. _ . :: <br />PROJECT SITE ADDRESS: �_..--� �.�_ . i� _. PROPERTY TAX #: <br />ILEGAL for new construction: Short Plat/subdivision `�� �J Lot No. (attach copy of long legal description) I <br />� <br />ing Use of Building: <br />�sed Use of Building: <br />ing Type: ❑SFR-Detached ❑SFR-Attached <br />of Project: ❑New DAddition C7Remodel <br />�RIPTION OF WORK: <br />IL <br />Contract Price of Work: <br />Heat 5ource: ❑Gas <br />❑Duplex �Multi-Family-# of Units:_ <br />C7Repair L7T.1. C7Sign �Sprinkler <br />❑Electric <br />❑Demolition <br />❑Other <br />ommercial ❑Industrial <br />OChanqe of Use <br />�ASSOCIATED BUILDING PERMIT # (if applicable)� � <br />ACKNOWLEDGEMENT.� ! have reviewed this appiication 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 first be authorized in writing from the <br />Building Official before being aufhorized under any circumstance. I am the owner, or I am authorized by the owner of this property to perform the work for which application is made, <br />and I comply wiih fhe State Contractors Law 18.27 RCW and 296.200A WAC. <br />� � � ��C���{'�c��� � <br />luth rized Agent gnature <br />�- � 2- t � .�, <br />City of Everett Offraal Use Only <br />PERMIT # <br />�� l (�C -- �� 1 <br />(Revised 10/12/2015) <br />