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� <br />� <br />� <br />• PERMIT APPLICATIOI� <br />BUILDING / MECHANICAL / PLUMBING / 51GN 1 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 />� ,n� v r t4 �-...� 'D <br />PROPERTY TAX #: <br />LEGAL for new construction: Short PlaUsubdivision Lot No. (attach copy of long legal description) <br />' ` ' BUILDING PERMIT APPLICATION ` . ` <br />_ _ <br />Existinp Use of Building: �J/j ��� c:� GI�'' , Contract Price of Work: $� r�� � <br />Proposed Use of Building: `� Heat Source: ❑Gas ❑Electric ❑Other <br />Building Type: FR-Detached ❑SFR-Attached ❑Duplex ❑Multi-Family-# of Units: ❑Commercial ❑Industrial <br />Type of Project: ❑New ❑Addition ❑Remodel ❑Repair ❑T.I. ❑Sign ❑Sprinkler ❑Demolition ❑Change of Use <br />DESCRIPTION OF WORK: �.� �� � � L � ���f- ��,� (�y�'� �js j�S1,�LS .— `�� ��AC� <br />�,1 �-1���11�� � �� C-�Cr» �� Go vt�Z `�� cica n� w TT'-/-�. `" Sa�'@ C�v s-LP�`. <br />v.-� � t� C�� r��t j.� vn/ S i'� �1 C�'A. i�-T a�e� �`� �-1' rC r o—T `y 4 S a' u.dc_. t` s�.c � nr: C�' <br />ASSOCIATED BUILDING PERMIT # (if applicable): _ <br />ACKNOWLEDGEMENT.� I have reviewed this application and confirm the information contained herein is true and correct Work done pu�suant to this perm�t musr compry wim <br />current federal, state, and local /aw. The grantrng of a permit only authorizes approved work and no deviations therefrom. Deviations must frrst be authorized in writing from the <br />Building Official before being authorized under any circumstance. I am the owner, or I am authorized by the owner of fhis property to pertorm the work for which application is made, <br />and 1 comply with the State Contractors Law 98.27 RCW and 296.200A WAC. <br />Ciry of Everett Off�aal Use Only <br />PERMIT # <br />L1/ � ��� v� �� C✓� �� i <br />(Revised 10/12/2015J <br />