2827 104TH PL SE 2017-01-13 - Laserfiche WebLink

lue or Black Ink PERMIT APPLICATION BUILDING / MECHANICAL / PLUMBING / SIGN / SPRINKLER / 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 � Please) PROJECT SITE INFORMATION - _ - .�: i,- PERTY TAX #. i- : r ; , ,, , _ > PROJECT SITE ADDRESS' r` .' .��- �� 'b :r � — (_ �_,:_ � .._ PRO _ � �•�—. •-- � �- `- .�_ =- LEGAL for new construction: Short PlaUsubdivision Lot No. (attach copy of long legal description) BUILDING PERMIT APPLICATION Existing Use of Building: c� �. ��,�� `' k �_: ;;� �� 1' �-� Contract Price of Work: Proposed Use of Building: `—„�� `� "k=�:�—�� s�.� Heat Source: ❑Gas Building Type: F1SFR-Detached �❑SFR-Attached ❑Duplex ❑Multi-Family-# of Units:_ Type of Project: ❑New �Addition ❑Remodel ❑Repair ❑T.I. ❑Sign ❑Sprinkler DESCRIPTION OF WORK: IIi��.,allil�c'� i�rea�•W' �?�� c::fr��/��:: 6�rr.(i��' SOCIATED BUILDING PERMIT # (if applicable): �,,, _ �> r-, ❑Electric ❑Other_ ❑Commercial ❑Demolition ❑Chan� ❑Industrial of Use 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 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 Building Official before being authorized under any circumstance. I am the owner, or 1 am authorized by the owner of this property to perform the work for which application is made, and 1 comply with the State Contractors Law 18.27 RCW and 296.200A WAC. � �: i ce j a/ Agent Signature City of Everett Official Use Only PERMIT # n n � � �%h Y►'� � �'I (Revised 9/23/2016)