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PERMIT APPLICATION <br />BUILDING�MECHANICAL / PLUMBING I SIGN / RINKLER / DEMOLITION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />(P) 425-257-8810 I FAX 425-257-8857 I(E) everetteps@everettwa.gov � www.everettwa.gov/permits <br />�- BUILDING PERMIT APPLICATION _.J <br />Use of Buiid <br />Contract Price of Work: <br />�oposed Use of Building� �Heat Source: ❑Gas ❑Electric ❑Other <br />�ilding Type: ❑SFR-Detached ❑SFR-Attached ❑Duplex ❑Multi-Family-# of Units: ❑Commercial ❑Industrial <br />/pe of Project: ❑New ❑Addition ❑Remodel ❑Repair ❑T.I. ❑Sign ❑Sprinkler ❑Demolition ❑Change of Use <br />ESCRIPTION OF WORK: / ,, ,/�� <br />(� �_ 5 �n r C, s,i,..,-� c�e.�%. i� ct�, r�t_✓b�,� !�O-,� p S 1` c� �L� (.UC/� �i,L I'E'�'. <br />IASSOCIATED BUILDING PERMIT # (if applicable): <br />ACKNOWLEDGEMENT: I have reviewed this application and confirm the information confained herein is true and correct. Work done pursuant to this permit must comply with <br />current federal, state, and local law. The granting of a pe�mit only authorizes approved work and no deviations therefrom. Deviations must fi�st 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 this property fo perform the work for which application is made, <br />and I r.omolv with the State Contractors Law 18.27 RCW and 296.200A WAC. <br />� � G/�ji�20�b <br />OwnerlAu horized Ag t Signat e at� <br />City of Everett Official Use Only <br />PERMIT # _ .�/� <br />vl <br />(Revised 10/1 /2 <br />