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F�l =�••� ;�T ��' `�"�� il h �� �>.� <br />f_' .— i� : i' I � r= .i i-i I i �� <br />��q@���1�l��Itil��tl-I�IC10�9�,�����l�������I�������I�I�L �f`�/��YY1��9�p�9� <br />� CITY OF EVERETT P�RM1T SERVICES <br />3200 Cedar St., �verett, WA 98201 425-257-8810 FAX 425-257-8857 www.everettwa.Qrg <br />TAX #i <br /># <br />�� <br />for new construction: Short Plat/subdivision � Lot No, (attach copy of long legal descriptiDn) <br />t �{,,���j/'�;S ��,�1� �V'ri • Phone/E-mail <br />!� :� "� ; %3?,�l•.,, , � i 1✓_�-u City/State/ZiP ���,��✓-�—f-� L� �- �% �2� % <br />;��Owner _ Owner's Agent _ <br />CO�tfaCtDi's A9e�t _ TeT1811f (musl provida a lalier of consenl from lhe owne� lo dp worh In 1he space) <br />���. #(,z � 3- c�l-1 —�C��S c�ty aus. �.��. # O 3 <br />Phone/Email `� `7 � � - � / � �J S � v <br />� J�? <br />BUI�.DING PERMIT APPLICATION coNTRacT PRICE oF woRK <br />Exisfing Use �f Bullding � HEAT SOURCE: <br />Proposed Use of Building �as_ Electric_ other <br />Building type: � Single Family _ Duplex _Townhouse _ Multi-Family _ Commercial <br />Type of project: _. New _ Addition _ Remodel _ Repair _ T.l. _ Sign _Sprinkler _Demolition_Change of Use <br />DESCRIPTION OF WORK (additional space provide n the back) : — � <br />�-' �j�- l. V � G,�-�.- � � <br />=���.�.��i �.�.�.-�-� �:_� � �f, .������ � '� � <br />,,:� ��� i'�,,,� � , <br />of Project: _,New _Addn _Alteration _Repair <br />5how Number (#) of fixfures <br />A/C — air handling units <br />heater <br />0 <br />SPR1IdKL.ER / SUPPIRESSIOid Sl(STEM <br />Number of Heads <br />of Project: _New _Addn �,Alteration _Repair <br />5how Number (#) of fixfures <br />Shower <br />Kitchen sinH <br />Dishwasher <br />rease <br />Medical Gas <br />Other: <br />Other: <br />basi <br />I hefeby certify thai I have read and examined this application and know ihe same io be irue and correct. All provislons of laws and ordinances governing this lype of work will be complied <br />wiih whelher speclfied herein or not. The graniing of a permit does noi presume io give authority to violate or cancel ihe provision of any other siate or local law regulating conslruclion <br />That I am aulho 'zed by the owner of /this property to perform the work for which application is made and I comply with the Siate Coniractors Law 1 a27 RCW and zg6.2DOA WAC. <br />� ` ' -" — �� �� ' ps (Revised 4/2015) <br />O ner/Authorized Agent Signature <br />