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O1/06/2p16 WED 10:35 FAX Fd�t water HObtOY ��Q2/QQ3 <br />�PERMIT APPLrCA�`��I <br />BUII.D�NG/MEChiANICA�./�'LUMBINC/SIGIV/S�RINKLER/D LITION <br />ClTY OF EV�FtETT PERIVIIT SERVIC�S ����.0(�� <br />3200 Cedar St., Everett, WA 98201 425-257-8810 FAX 425�257-8857 www.everettwa.org <br />� <br />LEGAL for new construction: Short PlaVsubdtvigion �at No. (atteCh copy of lonc� legal dgeCrlptivn) <br />OWNEF2 1' `�'K 8��/ 1 T I�US .� Phone/E-mall `�I ��r.�:-�`, � a �,-���� <br />(CANT: ,� Owner � pwner's Agent � Contractor <br />BUILDING P�RMIT APPI.iGAT10N <br />� <br />Cfty/Statel2lp �,%���T� ��� �g� <br />Contf�Ctof'S Ag�nt � Tenant (m�e! pravrdm a letter of conaenl from Ine owner to do vrarkln lhe epace) <br />State Lfc. �A rf�j'��,/LJI/,J <br />f . . Phone/Emall a� (u <br />JNTACT FOR PERMIT <br />� � ��L� <br />onalE-mall <br />aN'FRACT PRICE OF WOfiK <br />Existing Use of Bullding <br />Proposed Uae of Bui ' <br />Bullding type: 5in�le Family Duplex � �own Multi-Famlly � Commerclal <br />T e of rd�cr. New Additlon Remod Re alr i,l. SI n S rinklo <br />DESCRIPTION �F WORK (eddltlorral spac� provlded on tha back) : <br />S <br />Eleotrlc <br />Bus. Llc. <br />��� �� � � � � � �c�� ��� <br />� <br />MECNANi�AL PERMIT APPLICATIpN <br />Typ� of ProJect: _New�,}lddn _�11ter�tlon_Repalr <br />A/C — alr handlin units <br />Forced alr s stems <br />Gr�S i in <br />Water hg8tgf <br />G�e firaplace <br />Gae ran�e <br />Clothea dryer � <br />Range hood <br />�xhaust Pan �'T' <br />Haat um <br />Uhit heater <br />Boller <br />Refrlgeratfon <br />Woodstave �� <br />I Other <br />SPRINKLER / SU <br />Number of Weads <br />ION SYSTEM <br />PLUMa1NG PERM17 �1PPLICATION <br />Type of ProJact: _Hew �ddn _Alterativn <br />Show Numb�r # of ilxfures <br />I Toifet <br />__ Bethtub � <br />Shower <br />Kllchen sl $ � <br />Dfshw er <br />Cla s washer <br />ter heater <br />Roof dralns <br />Medical Gas <br />Other; <br />Other: <br />tor <br />In <br />� <br />I hereby aertlfy lhal I ha�e road ena gxaminvd Ihla applloallon end know the same �o he true and c❑rrect. All proWeione oF lawa �nd ordlnancea govem{ng lhle ryp of work wlll be aomp <br />wlth whalher 9peolllod hareln or noL Tj�e granling of a permlt d0es nol presumg �o glve �ulhorlty to vlpl¢�t9 0� cancel lhe provlgl0n ot any o{her ate�o or IOGdI IA�w regulaFlnO conslru6Uon <br />That I am au(npYl28tl by the owner f tFlls pYoperty lo perfOrm Ihe work For whlch AppI�CAlIon la metlo antl 1 OOmply wll� the Sla(b Canlraclara w 1e.Z7 RGW $qd 286200A WnC. <br />j � �v� <br />/ 1 /1 �,/'� �� % <br />`(( � � C � '�' a i- <br />Ow IAuthorlaed 9ent 8lgnatura Daie (RBvisod 4/2016) <br />