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� s <br />. • <br />PERMtT APPLICATION <br />BUILDING/MECHANICAL/PLUMBING/SIGN/SPRINKLERIDEMOLITION <br />CITY OF EVERETT PERMIT SERVICES <br />3204 Cedar St., Everett, WA 982Q7 425-257-881Q FAX 42�-257-885T www.everettwa.ar�g <br />APPLICATIONS ARE ACGEPTED FRONi 8 AM TO 4 PM <br />� � Dr. <br />IL for ne�v construction: Short PlaUsubdivision Lat 9Vo. {attach copy of bng legai descri�ion) <br />ER (3o,rba� � Ca,�b� i I Phone/E-mai( y a s' - a 6 5� 9 bq b <br />n <br />� <br />�'V� <br />� Ovmer _�Owners Agent _ Contractor _ Contractot's Agerit _ Tenant �mus� prwide a iener ot consent trar� u�e wrner to do wo�x �, me �,ace� <br />& I L�c. # <br />BUILDING PERMIT APPLICATION <br />COE Bus. Lic. # <br />OR PERMIT �� Y[� e � M� <br />UAs••�bS-969b �� yo15� � 3��l ' 996 g <br />PRICE OF WORK TMt � Mw'f(riQl <br />Existing Use of Building _Cl�to�t �� w0 r� y,� W� 0►1�^I?��n��i �S HEAT SQiJRCE: <br />Proposed Use of BuiPding �(�Int�- Gas Electric�C omer <br />Suilding type: � Sing{e Femiiy _ Juplex _Townhouse _ NluEFi-Family � Commerciai <br />Type of project: _ New _ Addition _ Remodei � Repair _ T. i. _ Sign _Sprinkter Demolition_Change of Use <br />�-- <br />DESCRIPTiO OFWORK( tspace vrcledonmeback}: R+,� a,�y � a�l d0�t�0,��Ct '�� �„FiS�'�r f t'ut� <br />C0.v3� d�Q � E ��'c %���A-�t�t,s � lk�`,� �ro w..*,`, � c� tti-k a� ' <br />o•� ��.c. t�a t c1k `.Z•�l� 0 Qt��� ;►� �` be.c1� �4oJ �� t Qt�ti�i'�j ^d� � � oly�p•c <br />,t Prs �f ��'c GcSnd �� c W� Is. Jbiccv� <br />d- cow��1y; ��o a`t �o � �I cuc'T��.� Q� �`) c�'+� c,�s� a,� �� v�u � ct - i� <br />MECHAf�I1CAL PERIVNIT APPLlCA�TIQIN PLUMBING PERMIT QPPLICATiON <br />of ProjecY: _New_Addn _Aiteration �S Repair <br />Show Number (#J oi tixtures <br />A!C — eir handling units <br />Forced air systems <br />Gas piping <br />V!jater heater <br />t�as range <br />Ciothes dryer <br />Range hood <br />Exhaust fan <br />Heat pump <br />Unit heater <br />Boiier <br />Refirigeration <br />Waodstoue <br />Qucting <br />Other <br />SPRINKLER / SUPPRESS <br />Number of Heatis <br />of Project _New_Addn _Alteration _Repair <br />Show Num6er (#) of fixtures <br />BathWb <br />Lavatory (wash ba� <br />5hower <br />Kitchen sink 8 disp <br />Dishwasher <br />Ciothes washer <br />Water heater <br />Sink (senrice/bar!m <br />Backflow preventer <br />J� inal <br />Drirtking Fountain <br />Floor drain <br />Grease trap <br />Roaf drains <br />Medical Gas <br />Other: <br />Ofher. <br />f hereby certify that f have read and examined this appiication and know the same to be true and correct. Ali provisions of laws and ordinances goveming this type of work will be comptied <br />with whether specfied herein or not The g2nting of a permA does not presume to girve authorRy to violate ar cancel the pmvision of any other state or local law regulating constructbn <br />That I am au[honzed by the owner of this property to perform the work for which appiication is made and I comply wrth the State Conhactors Law 1827 RCW an� 296.260A WAC <br />Owner/Authorized Agent Signature Date (Revised 6/20�2J <br />