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From <br />� <br />11/�/2013 07:42 <br />. . ,._ <br />� i' � 'i. ,1 = 1: .._ .-g � <br />t �- <br />#481 P.002/002 <br />� �� � � �� �� <br />�'dEie.f��G��������l�i����/E f.��6��/E�t�������,����E����FV��t6Q��l�B�f� <br />CITY OF EVERETT P�RNfiT SERVICES <br />3200 Cedar St., Everett, WA 98201 425-257-8810 fAX 425-257-8857 www everettwa.org <br />APPLICATIOAlS ARE ACCEPTED FRONf B AM TO 4 PM <br />SITE ADDRESS: � � � PR�OPE � 7Axii <br />� �� p�, /.�/�y P R 1T # , �� <br />' V (J � � ,� V �..J <br />LEGAL for new construction: Short PlaVsubdivision Lot No. (attach copy of long 4egal description) <br />OWNER t�t 0 _� • , Phone/E-mail r�i7 " r lJ —� l� � r� <br />4ddress ���� 1 �"�' � 1 � Ci �" �" � � CitY/State/Zip I �' �.7�.� ��C! �J ^� `"� �_ � (`� �V, �� <br />APPLICAN7: ` Owner _ Owner's Agent � Contractor <br />CO��fBctOYS f�qB�Y , Terta�i (must provldc a latlor uf conseM Irom Ne own¢r (o tlo work In the space) <br />CONTRACTOR ���-i'_�£� �{a�e.� IL & I Lic. #� 5��� 1�G <br />Address ��l�y1S North C:reek�parkway Soufh, Si �G106 gothell, WA 980i1 ;ma�j <br />TEIVANT BUSINESS NAME CONTACT FOR PEitM1T �� <br />��-J`'� �( `�� <br />Phone/E-mail � @� <br />����-���� �����T ��������F�� CONTRACT PRICE OF WORK <br />Existing Use of Building �,��.F�/}� 1bI �,V � <br />Proposed Use of 8uilding <br />Building type: � Single Family _ Duplex �Townhouse Multi-Family _ Commerciai <br />T e of ro ect� New Add 1� R d <br />�b�- COE Bus. Lic. # �j 5 <br />�s-1-�a-Ee..c-�lea-i�,c� � <br />1 CO� � 0��� . <br />f l�%C��' �� • ��'Y�. <br />---r---�_ <br />NEAT RCE: <br />Electric Other <br />yp p} _ i ion emo el Repau Sign Spnnkler Demolition Change of Use <br />bESCRIPTlON O� WORK (addrtionaispace provided on the back): <br />���U � � �� ��, ��.��' �y � ��'� �.��'� <br />��c��r��c��. ���n�e� ���Loc��roo� <br />7ype of Project: _New _Addn ,_Alteration _Repair <br />Show Numbe� (#J of iixiures <br />A/C — air handling units <br />j Forced air systems <br />Gas p'tping <br />Water heater <br />Gas firenlace <br />+ Heat pump <br />Unit heater <br />+ Boiier <br />! Refrigeration <br />� Woodstove <br />_ _ ; Ducting <br />' Other <br />��E'€EPlKE,.�R / ��P�����E�� �lt� <br />Number of Heads <br />PE.Uf�1�6N(9 PEEtRl71T APP�.6CAT60N <br />ofProject: �New_Addn `Alteration,_Repair <br />Show Number (t�) of fixtures <br />l.avatory (wash <br />Shower <br />Kitchen sink & <br />Dishwasher <br />Clothes washei <br />Water heater <br />Sink (service/b� <br />Backflow preve <br />Drinkin� Fou <br />Fioor drain <br />Grease trap <br />Roof drains <br />Medica! Gas <br />Other: <br />Other: <br />bas <br />nter <br />I hereby certify that 1 have read end ezamined �his appl3cation and know the same lo he true and correcL Ail provisions oi laws and ordinences goveming this lype of woik w��l be complietl <br />with whelher specified hereln or not. The granting of e permil does noi presume to yive authonry to violate or cancei Ihe provision of any other state or locai law iepuiating r.onslrucGon <br />Thst I am eulhonzed by Ihe owner of this property to per(orm ihe work for which application is made anq I compiy wiih the State Contractors 1.aw 1827 RCW and 29�.200A WnC. <br />- ' t <br />I � f • <br />�v�r,�eY/A onzeo r�ger�� Signatu�e Uate <br />i�. <br />(Revised 6/2072) <br />