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i • <br />PERMIT APPLICATION <br />BUILDING/MECHANICAL/PLUMBING/SIGN/SPRINKLER/DEMOLITION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 Cedar St._ Everett, WA 98201 425-257-8810 FAX 425-257-8857 www.everetfinra.org <br />ADDRESS: ����2 �, PROPERTY TAX # <br />--1-�`�' i�ti�� � � fZ I � � ����k �i-'�.'�; � � � �—�j`�j `� `� � � � <br />C .,� � <br />LEGAL for new construction: Short PlaUsubdivision Lot No. (attach copy of long legal description) <br />ER � I •� I� <br />�� <br />l�' � w K��' I� i�� <br />���1 <br />Phone/E-mail C�'�7ui5' C� L�mC��S �• YI(� t <br />City/State/ZiP �� ���� � ��� _ �V i� �� � � L�� <br />�PPLICANT: _ Owner X Owner's Agent _ Contractor _ Contractor�S A9@flt _ T8ft8flt (must provide a letter o1 consent hom the ovmerto do work in the space <br />:ONTRACTOR ��� State Lic. # City Bus. Lic. # <br />ddress Phone/Email <br />'ENANT BUSINESS NAME CONTACT FOR PERMIT C'���iSTz' F'�� 6 i'rl<>c" <br />�',.� Cc s�;��i FLc�wct�S �,�r. <br />�� ��' � I�i��� i � r Hi�cc' (�S c�� ctirl7/C�/v' <br />Phone/E-mail ��s"��'�3-��j5�,} /�;c3'2��pl,r�r.wu��C�'cc�jliint:�ru:��2ti. <br />BUILDING PERMIT APPLICATION <br />PRICE OF WORK <br />Existing Use of Building I�/�GC�S1in,'(� HEAT SOURCE: <br />Proposed Use of Building f�°«SS��✓� Gas Electric Other <br />Building type: _ Single Family _ Duplex _Townhouse _ Multi-Family _ Commercial <br />Type of project: _ New _ Addition Remodel Repair _ T.I. _ Sign _Sprinkler _Demolition Change of Use <br />DESCRIPTION OF WORK (additiona/ space propvided on the back) :���[c''C ��T1/ti C, ey�t (��u `I tS F= s%s /� (, ; C'/< j L�'i t'!1 �•�4 <br />l'�Y�l�'s�ZIiJG i (ili$47iCi.lM�G �/���,•� � p�il.niovC. ZV i��lN �'� �;,�ti,Din� �� INCLUS�iNG_ l� IU�W j��2aSrj� �LC`���n <br />�,':�iv LLi� kSh: /�c,�� � /�sv:) �V Lcv ���sST�'7�'IS Td�L/Nl.' /O /V,�o�l �iL.�T•i�(�,QiN/�CS . t�2s.4K <br />L iL1.-iCf�l✓V�:� �Z I�Fi�lLi�Q,1i2(ZS i1Nf) /ti,��TiPLL' /✓��C/Lc�4Jt}��5, <br />t2uc�;� �,,1��_ I�Av� aiiv�� �'Gi�Ji�� C, � , <br />lJ��l�VS /��/i� l��c`;1� Ni� �� ILiVt1jS {`c )� j7iCD��1i�v'� i/vi �c, t1',�� NV'�C S�s:�.�jc���lS Cl�r�fTi,ul . 3 o1Cr�'SarT. <br />MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br />Type of Project: _New _Addn _Alteration _Repair <br />`� Show Number # of fixiures <br />/ `�, A/C — air handling units <br />`°� i Forced air s stems <br />"e Gas piping <br />/ °�. Water heater <br />� , Gas fireplace <br />� ;�as ran e <br />� thes dryer <br />� Range hood � <br />� Exhau�s�fa� <br />Heat pum� <br />Unit heater`� <br />� 8oiler <br />Refrigeration �� <br />� Woodstove <br />/ Ducting <br />� Other <br />SPRINKLER / SUPPRESSION <br />I Number of Heads <br />M <br />of Project: �New _Addn _Alteration _Repair <br />Show Number # of �artures <br />� Toilet <br />Bathtub <br />Kitchen sink & di <br />Dishwasher <br />Clothes washer <br />Water heater <br />Drinking'F�ountain <br />Floor drain' .,. <br />Grease tra � <br />Roof drains <br />Medical Gas <br />Other: <br />Other: <br />I hereby certify that I have read and examined this application and know the same to be true and correct. All provisions of laws and ordinances goveming this type ol�work will be comp <br />with whether specified herein or not. The granting oi a permit does not presume to give authority to violate or cancel the provision of any other state or local law regulating construction <br />That I am authorized b e owner of this prope perform the work for which application is made and I comply with the State Contractors Law 18.27 RCW and 296.200A WAC. <br />`�� �/�� _-- � / � <br />.� ' / s is <br />Owner/Authorized Agent Signature Date (Revised 4P1015) <br />