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PERMIT APPLICATION <br />BUILDING / MECHANICAL / PLUMBWG / SIGN / ;INKLER / DEMOLITION <br />CITY OF EVERETT PERMIT SERVICES <br />EV 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 />_. <br />ROJECT SITE ADDRESS: > PROPERTY TAX #: � �., � � � .3 ,?�f � L� ,'- � � �-� <br />e l_J 7 _?_ .�1�'�%!_Ct'v'� _ <br />for new construction: Short PlaVsubdivision Lot No. (attach copy of long legal description) <br />� BUILDING PERMIT APPLIGATION I <br />Existing Use of Building: <br />Proposed Use of Building: �.�,4��3 G-�= <br />Building Type: ❑SFR-Detached ❑SFR-Attached ❑ <br />Type of Project: ew ❑Addition ❑Remodel ❑R� <br />DESCRIPTION OF WORK: �_ �, ,L � � ,��, , r- JL,��ti� <br />�ASSOCIATED BUILDING PERMIT # (if applicable): <br />Contract Price of Work: $ <-�' �. �"`- <br />Heat Source: ❑Gas ❑Electric ❑Other <br />aplex ❑Multi-Family-# of Units: ❑Commercial ❑industrial <br />air ❑T.I ❑Sign �Sprinkler ❑Demolition ❑Change of Use <br />`� S L- 5..� F! �) ci1`Ic' Yt'�'-�-.1 �!1, ?it G- G <br />ACKNOWLEDGEMENT: I have reviewed this application and confirm the information contained herein is true and correct. Work done pursuant ro this perm�t must compry wiui <br />current federal, state, and local law. The granting of a permit only authorizes approved work and no deviations therefrom. Deviations must tirst be authorized in writing lrorn the <br />Building Official before being authorized under any circumstance. I am fhe owner, or I am authorized by the owner of this property to perform the work (or which application is made, <br />and 1 comply wifh the State Contractors Law 18.27 RCW and 296.200A WAC. <br />City of Everett Official Use Only <br />� i <br />PERMIT # � <br />`/�'� Y:� .:_ � � � �''��,L..• 1 <br />OwnerlAuthorized Agent Signature Date (Revised 10/12/2015) � <br />r / �, !1 <br />r �- _ �-�'�'�'� <br />� , , <br />�: �,� � � <br />