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�'�'f�ill�I �' A�'�'L.,1�l�Tl�i� <br />�3L11�.�1�/ illfi��{-IA�IIC�d�Z� / ��.11�ifl��l�9� / �1� � ����.Ii��CL..�� / p��ilfiC�l.�l'�°1C,�1 <br />CITY OF EVERETT PERMIT SER � <br />3200 CEDAR STREET, EVF_RETT, W y8?01 <br />(P) 425-257-881 D � FAK 425-257-8857 �(E) evereiteps@evereftwa.gov � www.everettwa.gov/permifs <br />- <br />,. . ,. , . _ <br />- . <br />_BUILDING. PERMIT APPLICATION - <br />Existing Use of Building: Contract Price of Work: $ <br />Proposed Use of Building: Heat Source: ❑Gas ❑Electric ❑Other <br />Building Type: ❑SFR-Detached ❑SFR Affached ❑Duplex ❑Multi-Family-# of Units: ❑Commercial ❑Industrial <br />Type ofi Project: ❑New ❑Addition I�emodel ❑Repair ❑T.I. ❑Sign ❑Sprinkler ❑Demofition ❑Change of Use <br />� <br />DESCRIPTION OF, RK:� �i 7 e D �ry►� �e - T��iu �� ; FY� ,� %� � /7a�'1* f �/c �'J STL.i1' YN 'c�/�' <br />�P p�,Y � � <br />c1�Cr��r' S/u�r'�:�t�// C'vs���uru7 �.� ��VI�J"1!'1�--�Dvl Otf <br />�� ,��-ns �a'�e. <br />TED BUILDlNG PERMIT #(if applicable): C I��i Z- <br />.... . .. .. <br />PWIVIBING PERMIT.APPLICATION <br />Type of Project; _New _Addn _Alterafion _Repair <br />Fixtures �-�st of Fixtures Fixtures List of Fixtures <br />Toilet Backflow Preventer (Inside Bldg) <br />Bafhfub Urinal <br />Lavatory (Wash Basin) Drinking Fountain <br />Shower Floor Drain <br />Kitchen Sink & Disposal Grease Trap <br />Dishwasher Rooi Drains <br />Clofhes Washer Medicai Gas <br />Water Heafer Other: <br />Sink (Service/Bar/Mop/efc.) Other: <br />ACKNOWLF_DGEMF_NT.� 1 have reviewed this application and contirm the informafion confained herein is true and correct. Work done pursuant fo this permit musf comply with <br />cur�enf federa/, stafe, and local law. l he granting of a permit only authorizes approved v✓ork and no deviations fherefrom. Deviations must first be authonzed in v✓riting from the <br />Building Official before being authorized under any circumsfance. I am the owner, or I am authorized 6y the owner of this properfy to perform the work for which applicafion is made, <br />and I comply wrth the State Contrar,tois Law 18.27 RCW and 29G.7_OOA WAC. <br />er/Aufhorized Agent Signature <br />p�� Jzl j2a�� <br />Dafe <br />1 <br />City of Evereft Offcia/ Use On/y <br />PERMIT�1'� t ���� .- D�� <br />� � � <br />(Revised 5/?_0/7_096) <br />^ _ 1 ► <br />� 0 /�pj/O <br />