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� � <br />PERMIT APPLICATI� <br />BUILDING/MECHANICAL/PLUMBING/SIGN/SPRINKLER/DEMOL,ITION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 Cedar St., Everett, WA 98201 425-257-8810 FAX 425-257-8857 www.everettwa.org <br />SITE ADD /� �j <br />RES .+ ^, _ `� - r� r IPROPERTY TAX #J PE�R�MI� <br />`( fi.- 1��;_��� �i1 ��'� Lc�Jl�l� l�� ��!�-�'0 �, ��L'�l). <br />LEGAL for new construction: Short PlaUsubdivision Lot No. (attach copy of Ibng legal description) <br />lNER C t'E� ,(Z. t-� J( S C_.� �CY� C_ ��L.� �L 1! <br />\ ti <br />Iress "� Z � Z � L i •l�' 1 / ��F ( � <br />PLICANT: Owner _ Owner's Agent _ Contractor <br />ONTRACTOR f�; .;,, ,/ I 1; t,' <br />dress "��. I1X'x 1c�C� �`%`� Z.� ��: <br />'-� i: t7� 1 j� !� � Fi L i C � c'.I,�cG� c-- <br />� �--� ra�: �i- G�c� tiW� L �- � �' � � ,i <br />BUILDING PERMIT APPLICATION <br />Phone/E-mail � !�' `.1 . ?i4� ) Z�?:, •�I<&�' fl�, _ '_4, ., M` !). <br />city/state/zip � �; ,, ," (,L! ►-� �� 7 L �:' ��° � <br />Contractor�S AC]E�l _ T2f18f1t (must provide a let�er of consent from the owner to dp work in ihe space) <br />, �"�cr� r <br />, State Lic. # 1� '= } F � .►�j7 City Bus, Lic. # � Z�jL� <br />( . 5 , �- �-� i�� �-�, Phone/Email `�1 j -� <br />CONTACT FOR PERMIT <br />.��_E_�;� �Fcc�,�k-yci_ <br />Phone/E-m�ail `f•�:� - ,`�j.,i� -'c? <br />CONTRACT PRICE OF WORK <br />Existing Use of Building %G�Yt(�U l <br />Proposed Use of Building �7L�4 � Ga <br />Building type: ,_ Single Family _ Duplex _Townhouse _ Multi-Family ,`� Commercial <br />Type of project: New _ Addition _ Remodel Repai�.l.;i Sign _Sprinkler _C <br />DESCRIPTION OF WORK (additional space provided on the back) : � <br />/ 4'r /\ ` 3�.' I l.%- �JL,1.� �-' i 1 r� �i.'Y:.' ��. - <br />� <br />CAL <br />Type of Project: _New _Addn _Alteration _Repair <br />Show Numder (#) of fixtures <br />A/C — air handling units <br />Forced air systems <br />Gas pipinq <br />as nreplace <br />Range hood <br />Exhaust fan <br />Heat pump <br />Unit heater <br />Boiler <br />Refriqeration <br />� utner <br />RINKLER / SUPPRESSION SYSTEM <br />Number of Heads <br />HEAT SOURCE: <br />Ele <br />�' � � , <br />C:` IZ'�-� c; � , 1 ( <br />t `��: I <br />Change of Use <br />Type of Project: �New _Addn _,Alteration _Repair <br />Show Number (#) of fixfures <br />5nower <br />Kitchen sink & disposa <br />Dishwasher <br />Clothes washer <br />Water heater <br />Sink (service/bar/mop/� <br />Backflow preventer (in: <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 examined this application and know the same to be true and correct. All provisions of laws and ordinances governing this lype pf work will be complied <br />with whether specified herein or not. The granting of a permit does not presume to give authority to violate or cancel the provision of any other state or local law regulating construction <br />hat I am aut rize he owner of this/ g�r e toEerform the work for which application is made and I comply with the State Contractors Law 1827 RCW and 296200A WAC. <br />� + ( � .� E, l � �_ <br />�� <br />� � �� <br />w er/ honzed Agent Signature ate (Revised 4/2015) <br />t <br />!� <br />