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� <br />� <br />� <br />EGAL for new <br />� PERIVII`T APPLIC,4TI0I�� <br />BUILDING / MECHANICAL / PLUMBING / SIGN I SPRINKLER / DEMOLITION <br />CITY OF EVERETT PERMIT SERVICES <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,INFORMATION ' <br />r;G LC�e <br />#: <br />Short PlaUsubdivision Lot No. (attach copy of long legal description) <br />` _ ; . ' BUILDING PERMIT APPLICATION ' I <br />.. . <br />Existing Use of E3uiiding: J C'11` <br />Proposed Use of Building: S�1� <br />Building Type: dSFR-Detached ❑SFR-Attached ❑ <br />Type of Project: ❑New ❑Addition ❑Remodel �(R� <br />DESCRIPTION OF WORK: � � � ��� � � <br />G'�;a(' C'�1e,x� ��G.i� G'u'>�/, y�1 Y�•r� p�� . <br />IASSOCIATED BUILDING PERMIT # (if applicable): <br />Contract Price of Work: $ '"' <br />Heat Source: ❑Gas ❑Electric ❑Other <br />)uplex ❑Multi-Family-# of Units: ❑Commercial ❑Industrial <br />pair ❑T.I. ❑Sign ❑Sprinkler ❑Demolition ❑Change of Use <br />C�G�� �����'����Jl��� y�if>ti.r >��l�d r�.chey �/'ei��C �� <br />ACKNOWLEDGEMENT.• 1 have reviewed this application and confi�m the information contained herein is true and correct. Work done pursuant to this permif must comply with <br />current federal, state, and local /aw. The grantrng of a permit only authorizes approved work and no deviations therefrom. Deviations must first be authorized in writing from the <br />Building 0(ficial before being authorized 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 with the State Contractors Law ?8.27 RCW and 296.200A WAC. <br />O! <br />�� <br />Owner/Authori <br />Agent Signature ` Date <br />�� <br />o� <br />C�ty of Everett Offic�al Use n y <br />PERMIT # <br />� <br />, <br />(i7evrsed 10/12/2015) <br />� <br />