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�ERMi,-AP�L�cA-ri� <br />BUILDING/IlIIECHANICAL/PLUMBING/SIGN/SPRINKLER/DEMOL,ITION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 Cedar St., Everett, WA 98201 425-257-8810 FAX 425-257-8857 www.everettwa.org <br />� �......�.,... Z-% L l� l�� <br />3AL for new construction: Short PlaUsubdivision <br />�NER ��(��L(, <br />ress Z j� �� /"� �'�� u3-� w✓�-�-. <br />'LICANT: ' Owner _ Owner's Agent _ <br />NTRACTOR '1—C S �. co2 •�-- �c ey <br />ress (p Z.S �S�t�"i- �-✓}'H'� <br />�g � �lG S � � —c ..r=� ,,�,� �-t � Fv ^� � <br />'\ PROPERTY TAX # ERMITp # ,/� <br />� L �J� C' <� �;L L- � � � �%� J (/ry� ! <br />, <br />Lot No. (attach copy of Ibng legal description) <br />Phone/E-mail �"�Z ,- Z S�j !�r� 7 W <br />City/5tate/Zip �v�,�-� � �,1/,/}- GL��� � <br />Contractor _ Contractor�5 A9ef11 _ Tef18111 (must provide a letter of conseN from the owner to dp work In the space) <br />State Lic. # ;%� (-FIE�Z�7 �� City Bus. l.ic. # 03� �Z <br />Phone/Email �G�� --��� — �C���( <br />FQR PERMIT <br />� l j�l,� �✓'��C (,C-s v �i <br />�i �`z.�=ZSS'-3�'1v Clr�7�oj��.���;N�n�;t��. �'°�� <br />BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK t,� 0 <br />Existing Use of Building �+'�f L�� ��`= <br />Proposed Use of Building �J�/ � t�^-� � i� <br />Building type; � Single Family _ Duplex _Townhouse _ Multi-Family _ Commercial <br />Type of project: New Addition Remodel Repair _ T.I. _ Sign _Sprinkler <br />DESCRIPTION OF WORK (additional space provided on the back) : <br />r . p <br />u��� i-01'Vl h'1 l51 G'Vl I Vt.a� 8��1.�, V'�1�`�� <br />of Project: _New _Addn _Alteration _Repair <br />Show Number (#) of fixtures <br />A/C - air handling units <br />-� Forced air sVstems <br />dater neate� <br />ias fireplacE <br />�as range <br />lothes drye <br />ange hood <br />xhaust fan <br />eat pump <br />nit heater <br />oiler <br />efriqeration <br />I uucting <br />� Other <br />SPRINKLER / SUPPRESSION SYSTEM <br />,'� /� Number of Heads <br />HEAT SOURCE: <br />Demolition ChanQe of Use <br />Type of Project: _,New _Addn _,Alteration _Repair <br />Show Number (#) of fixtures <br />Bathtub <br />Lavatory (wash ba: <br />Shower <br />Kitchen sink & disp <br />Dishwasher <br />Clothes washer <br />Water heater <br />Sink (service/bar/m <br />Backflow preventer <br />Urinal <br />Drinking Fountain <br />Floor drain <br />Grease trap <br />Roof drains <br />Medical Gas <br />Other: <br />Other: <br />;I� c rtjfy tha have read and examined this application and know the same to be true and correct. All provisions of laws and ordinances governing this type of work will be complied <br />w h�r spe fied herein or not. The granting of a permit does not presume to give authority to violate or cancel the provision of any other state or local law regulating construction <br />I uthori e�i y the owner of this property to perform the work for which application is made and I comply with the State Contractors Law 18.27 RCW and 296200A WAC. <br />!�� ;� �-z-�_� S- <br />re <br />(Revised 4/2015) <br />��� <br />