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1 L..f\1�1� I!"�� � V�vn � �v�� <br />BUILDING/MEC�NICAL/PLUMBING/SiGN/�'�INKLER/DEMOLITION <br />CITY OF EVERETT PERMIT SER ES <br />3200 Cedar St., Everett, WA 98201 425-257-8810 FAX 425-257-8857 www.everettwa.org <br />ADDRESS: , c-- <br />�; � � / ►`-1 ��'. <br />eanr rax a <br />c�.�-4?. oo /�d v � v <br />_EGAL for new construction: Short PlaVsubdivision Lot No: (attach copy of long legal description) <br />JWNER ������ f�U�fl/V(j �G�T�� PhonelE-mail �,( .���l9 , � L� � <br />4ddress�4 �l%� �,�� CitylStat�p ��/��%T ,�it/T� (J G �� " <br />APPLICANTt,� Owner _ Owners Agent _ Contractor _ Contractors Agent _ Tenant �m�5� Pro�ae a ianar or c«,g�r,t rrom v,e owner co do wo�x in u,e sPace� <br />CONTRACTOR /'�N�c��� State Lic. # ��� �� �(7 � � City Bus. Lic. ���, % '� <br />�����1�� <br />BUILDING PERMIT APPLICATION <br />Phone/Emaii <br />�ONTACT FOR PERMIT �N�.�/ ��'� T^,/� <br />PhonelE-maii ��.s- � 93�"6 �3 �� <br />CONTRACT PRICE OF WORK ��O � d. _� <br />Existing Use of Building J`/L' K HEAT <br />Proposed Use of Buiiding �/�/`� � Gas EI <br />Building type: _ Single Family _ Duplex Townhouse _ Muiti-Family _ Commercial <br />T,rP �f project� New Addition .� Remodel Repair T.I. Siqrt Sprinkler _Demoliti� <br />DESCRIPTION OF WORK (additional space provided on the back): <br />���� I��_�� �,�.� r���.c.� �- �1� fi �,��� ���+�' �1�:;�%vF-��.f <br />� <br />MECHANICAL PERMIT APPLICATION <br />of Project: _New _Addn /� Alteratlon _Repair <br />Show Number # of flxtures <br />A/C — air handling units <br />Forced air svstems <br />hood <br />,t fan <br />SPRINKLER / SUPPRESSION SYSTEM <br />Number of Heads <br />Other <br />of <br />PLUMBING PERMIT APPLICATION <br />Type of ProJect: _New _Addn _AlteraYion _Repair <br />Show Number (#) of tfxtures <br />i ouet <br />Bathtub <br />Lavatory (wash basin) <br />Shower <br />Kitchen sink & disposal <br />Dishwasher <br />Clothes washer <br />Water heater <br />Sink (se�vice/bar/mop/etc.) <br />Backflow preventer (inside <br />Urinal <br />Drinking Fountain <br />Floor drain <br />Grease trap <br />Roof drains <br />Medical Gas <br />Other. <br />Other: - <br />I hereby certify that I have read and axamined this application and know the same to be uve and correct. All provislons of laws and ordinances govem{ng this type of work will be cor <br />with whether sp ed herein or not. The granting of e permlt does not presume to gNe authority to violate or cancel the provfslon of any other state or local law regulaUng constructl <br />That I aut ori d by the ner of this property to pertortn the work forwh�h applicatlon Is made and I compy with the State Contractors Law 18.27 RCW and 298.200A WAC. <br />-��� �: � ��- <br />Owner/Authorized Agent Signature Date (Revised 4l2015) <br />