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� <br />�� <br />PERM17 APPLICATION <br />BUILDING I MECHANICAL / PLUMBING I SIGN / SPRINKLER I DENi4LITIQN <br />CITY C3F EVE42ETT PERMIT SERVICES <br />32Q0 GEDAR BTREET, EVERETT, WA 38201 <br />(P} 425-257-�810 � FAX 425-2�7-&857 j(E) everetteps�everettwa.gov � www.evereltwa.gpvlpertnits <br />fae or Blaak Ink Only Please F�RO.lIEC'6' 817� 1[d�4RM/►TIGN <br />DJECT SITE ADDRESS: �zZ�i �'(,UE Sj 1����r� '� Ri��j( pRQPERTY TAX #: �{��`Z'�LS <br />3AL for new consUuction: Short PlaUsubd�v�sion „Lot No _(ettach oopy oi tong lega( description) <br />f BUIIDING PERMIT APPLICATION �(eSti�_`� . i <br />Use of Buildin : Coni�act Price of Work: S Tr. � <br />d Use of euilding: << �• �` Heat Source ❑Gas ❑Electric <br />luildin T e: ❑SFR-Deta ❑SFR-Attached ❑�� lex ❑MulU-Famfl -# of Units L�Commerciei ❑IndusVial <br />'ype of Projed ❑New Addition ❑Remodel ❑Repeir ❑T.I. �5ign C7SPnnkler CJDemolition C1Change ot Use <br />IESCRIPTIaN OF WORK: j� STI� LLA�TIQ I�I � F ���Q- ��E�T O� %21 � N U d1'1�lV AL �,o PPER "�C3 ��� <br />ATT I�Gµ E I� '("'d -n{ E u 1,�,-� 51 � E W ALL S 0 N il� E S ot.� �l 14IY 1) EQ5T S t D ES o G TN'E <br />i3k�LDI�/G. �'Rat�REss F� TT IN CxS WILl 13ElASED.1�5a(-�: UasLo�s rv� rt'R��� SkPP�[y <br />�SSOCIATED BUILDING PERMIT # (if aoolicablel: <br />AL'KNOWLEDGEMENT ! have r�viewetl (h!s eppliCation end conlrm the in(ormation contamed herein is true end conecL Work done pursuent to this permd musl comply wrt� <br />current fedarat, state, and /oca! lax• TAe g�anting o! a permd only authonzes eppiuved work and no dav�a!rons therefrom Devisfions musf first be authonzed in wdting Irom the <br />Buikling Qflicia� belare g authorized under any urcumslance. ! am the owner, or I a.m authonzed by the ovmer of fh, rs prope+ty to peAoml the work fnr which applicaticn is made. <br />and I co,p�ply�wRh fhe ta� Contracfors Law 18 27 RCW and 296.200A WAC <br />c�wnenqutn nzea a ent �ign u Date+ <br />�A�.� 1 � ��SIG�t�� �aN�' C�+�pfs/ ��CGt <br />City ol EvereB ONrciat Use On�y <br />PERti1 O f <br />�+ U <br />(Revised 5? /2016) <br />