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. ������ b�iT'���� '/�=����� <br /> ��d�L-�Iq��J�9�YN��id�ll.l���71�i�l�/�1�����1"S��J/e��UAC!/��4���9'1�������u�lN��,��U�II� <br /> � ������ ������� �������������� <br /> 3200�Cedar St., �verett, WA�82Q9 �25-257-8810 FAX 425-257-8857 www.everettwa.�org <br /> SITE ADDRESS: PROPERT`lTAX# P��11;�o���� <br /> 52 5 ' S� • QD Q�20 00 ��Y t e <br /> L�GAL,for new construction: 5hort Platlsubdivision Lot No. (attach copy of lbng legal descriptiDn) ' <br /> OWNER �(� �j b �(�,_ Phone/E mail �Z � . `'�j� . . . .. <br /> Addfess "'L� �j�� �j�, ejC � City/Stafe/Zip �.(� t.t/ <br /> AI?PLICANT: Owner _Owner's Agent _Contfactor _�ontractor's Agent �Tenant(musi provida a IeRer oFconsBnlfrom�he owner ta dp worh In�he space) <br /> CONTRACTOR �1�� ����-� �`��� ������� Stafe L-ic,# �.��t��f���l � Clty Rus.L.ic.# �C�'�G��`� <br /> Address �1P7 t' ���f.� ��, �tl:�(Z"�,�. M;(,t•(� �O�( Phone/Email �Z j� "Z�2 ���'�-j <br /> COP1�'ACT t�4R PERMIT � <br /> TI�E 7�Z1'2�qG,�' ,,¢7 l3uicv�a�, rvl�tt�@ £SS,�tu/A .Ga� <br /> PhonelE-mail �27'�5�2-$✓�� <br /> BUI�,DING PERMIT.APPLICA,TION coN'rtaacT PRICE o�WOR�c �F�O <br /> Existing Use of Buiiding, �0 C���'� HEAT SQURCE: �_ ' <br /> Rt'oposed Use of Buildifl� �0 C�""��iti' Gas 1C Electric Other_ <br /> Building fype; ,_Single Family _,Duplex_,Townhouse _Muiti-Family �C Cammercial ' <br /> Type of project: _New _..Addition ^Remodel Repair_T.I._Sign_Sprinkler_Demolition_Change Df Use <br /> DESCRIPTION OF WORK(addifiona!space provided an the back): ' <br /> � R�2 �X15T�w6 C�� �tGNt4C6 - W t T!-( 5�-��` va�?. S�r�€"�oc�TeaJ <br /> �MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> TypeofProject: _,New_Addn _Alferation�,.,Repair , TypeofProject: _,New_Addn ,_,Alteration_Repair <br /> ShowNumber(#)offix[ures ShowNumber(#)offixfures <br /> ' A/C—air handling unifs � Toilet � <br /> Forced 'air systems Bathtub � <br /> Gas piping � l.avafory(wash basin). <br /> Water heater .SI-iower " <br /> ' Gas fireplace � Kitchen sink&disposal <br /> Gas range Dishwasher ' � <br /> Clofhes dryer Clothes WasheP � <br /> � Range hood Water heater <br /> � Exhausf fan � Sink(servicelbadmop/etc.) <br /> Heat pump Backflow preventer(inside bidgj <br /> Unif heafer llrinal - <br /> � Boiler Drinking Fountain � <br /> Refrigeration Flaor drain � <br /> Woodstove Grease frap <br /> j Ducting � � Raof drains ' ' ' � <br /> . � �Other ' Medicai�as <br /> SPI�II�IF��I�R/��1IPIP�I��Sll�Y�I ��(�`���11 Other. <br /> Number of Heads OtFrer: • <br /> • I hereby certify that I fiave read and examined this appl(cation and know ihe same to be irue and correct.All provis(ons of laws and ordfnances governing this iype of work will be�omplied <br /> wiih whether specified herein o�not,The granting of a permit does not presume io give aufhori�y to vlolate or cancel ihe prov(sion of any other staie or local law regulating construetion <br /> That I am auihorized by ihe ownef of this property to perform the Wofk forwhich application is made and I comply With tfie State Contractors!aw 18.27 RCW and 296.2DoA WAC. <br /> � g'�-�� <br /> ptv�ner�tuthoriz gentSignature . Date (Revlsed4/2015) <br />