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PERMIT �4PPLICATION <br />BUILDIYV( IECHANICAL / PLUMBING / SIGN I :INKLER / DEMOLITIOIV <br />CITY OF EVERETT PERMIT SERVICES <br />EV 3200 CEDAR STREET, EVERETT, WA 98201 <br />(P) 425-257-8810 � FAX 425-257-8857 �(E) everetteps@everettwa.gov � www.everettwa.gov/permits <br />' PROJEGT SITE INFORMAT.ION <br />, ,_. ,_ <br />_ _ . _ __ <br />�JECT SITE ADDRESS: e,� s_�.,^ � �� PROPERTY TAX #: ���� ��noo I4,or�o <br />�LEGAL for new construction: Short PlaUsubdivision Lot No. (attach copy of long legal description) � <br />Existinq Use of Building: ��.Ity�,� ��(�u <br />Proposed Use of Building: <br />Building Type: ❑SFR-Detached ❑SFR-Attached OD <br />Type of Project: ,,�TUew ❑Addition ❑Remodel �7ReF <br />DESCRIPTION OF WORK: <br />a�`'Q�G" �i�"�S�'�l �Y�-��:''C <br />�� <br />Contract Price of Work <br />Heat Source: ❑Gas <br />�Multi-Family-# of Units:_ <br />❑T.L OSign OSprinkler <br />�ASSOCIATED BUILDING PERMIT # (if applicable): <br />�� i3,Z00 <br />�Electric ❑Other <br />❑Commercial ❑Industrial <br />❑Demolition ❑Change of Use <br />ACKNOWLEDGEMENT.� I have reviewed this application and confirm the information contained herein is true and correct. Work done pursuant to this perm�t must compry w�rn <br />current federal, state, and loca! 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 Olficial before being authorized under any ciroumsfance. I am the owner, or I am authorized by fhe owner of this property to perform the worlc for whrch application is made, <br />anri I r.mm�lv with the State ContYactors Law 98.27 RCW and 296.200A WAC. <br />City of Everett Official Use Only <br />PERMIT# � Il C1,T �C � � <br />lC <br />(Revised 10/12/2015) ` <br />�z <br />