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� <br />� <br />� <br />� PERMIT APPLICATION� <br />BUILDINC�lJIECHANICAL / PLUMBING / SIGN /7RINKLER / 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 />PROJECT SITE ADDRESS: PROPERTY TAX #: i q <br />�u� ���i'�y�lcend �v� v�C�J��J�?��-��C�(7 1�'1� <br />LEGAL for new construction: ShoR Plat/subdivision Lot No. (attach copy of long legal description) <br />BUILDING PERMIT APPLICATION <br />Kisting Use of Building: Contract Price of Work: $`f Lf��i��'' <br />roposed Use of Building� Heat Source: ❑Gas �Electric ❑Other <br />uilding Type: ❑SFR-Detached (�SFR-Attached ❑Duplex ❑Multi-Family-# of Units: ❑Commercial ❑Industrial <br />/pe of Project: ❑New ❑Addition ❑Remodel �Repair ❑T.I. ❑Si n ❑Sprinkler ODemolition ❑Change of Use <br />ESCRIPTION OF WORK: �h� I,� �1�„� i� ,�� �-zr -F ` v � �2 �;� }✓ ��,St' S, ^✓�' W <br />W:uiU, �v7� NC'w dry�1-i�l( �-- `, b�j�,t�G(f":G�I <br />�ASSOCIATED BUILDING PERMIT # (if applicable)_ <br />ACKNOWLEDGEMENT.• 1 have reviewed this application and confirm the information contained herein is true and correct. Work done pursuant to this permit must compry witn <br />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 <br />Building Official before being authorized under any circumstance. I am the owner, or 1 am authorized by the owner of tl�is property to perform the work for which application is rnade, <br />and I comolv with the State Contracfors Law 18.27 RCW and 296.200A WAC. <br />l� _! <br />Agent Signature Date <br />City of Everett Official Use Only <br />PERMIT # <br />��_ l� I (��G�._�C� <br />(Revised 10/12/2015) � /'� <br />I <br />