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� <br />\_�I <br />PERMIT APP�ICA►TtON <br />BUILDING/M�CHANIGALfPLUMBII�G/SIGN/SPRINKLER/DEIIIIOLITION <br />C1TY O� EV�RETT PERMIT SERVIGES <br />3200 Ced�r St., �verett, VI/A 98201 4Z5-257-8810 FAX 425-257-8857 www.everettwa.org <br />SIT�ADCIRESS' PROPE 7YTAx# PERMIT# <br />� � 1�-e �-e. I � �c r �3 � 9 a ab � � .. <br />L�GAL tar new construction; Short PlaUsubdlvlsion_ Lok No. (attach capy of long legal Qescrlptlon) <br />gWNER Ea� 1 PhonelE-msll � D�p , a I Q .���.�' <br />PPLICANT= _ Oti�nar _ Ownere �r enf <br />CON7RACTOR <br />C3l)•/StatelZi p <br />Cpf1lf,�,CIOf _ COl1V3CIOY'S A�6fit _ T@Il3�lI �mucl pmvide a Icqcr Of xngenl frGm �he arvner to do work ln thc.ppcc) <br />State Lic. # � City Bus. Llc. #� d o{ $ d 0 <br />I.-(, 8 Pnonel�mail ��� l, t� •� QQ <br />cONTACT FOR PERMiT � m� t �.�v�.na-r1 <br />BUlLpING PERMIT pPPLICATIQN <br />PhonelE-mail, (�,� rn'�..L�� <br />CONTRACT PR�C� OF WORK <br />Existing Use of Building � �— �, � � <br />Proposed Use o# Builciin <br />Bl�iiding type' _ Singla Farnily _ DupI�X_Townhousg _ Multi�Family � Commerciai <br />T e of ro�ect: New Addition Remodel Re air T.I. Si n S rinhla <br />D�SCRIPTIQN OF WORK (adtlitional spece provided on the back) : <br />V �i �' � �-� 2 x I s�� G� �-t S � l.� r itA (�. <br />ea�r- <br />MECHANICAL PERMIT 4PRLICATION <br />7ype of ProjeCt: �Nsw _A�ldn _Aitaretio� �Rep�lr <br />Show Number # Of fixtures <br />NC — air handlin units <br />Forced alr s stems <br />Gas piping <br />Water heater � <br />Gas fire lace <br />Gas ranae <br />hood <br />f #a n <br />Heat I <br />UhiY h <br />Boiler <br />j Othor <br />SPRINKLER / SUPPRESS�ON <br />Number of Heads <br />� ,l � q , <br />H�qT 50URCE: <br />3,� E�eckric Other <br />L�emolition Chanae of Use <br />�- l� a.K-� <br />PLUMBING PERMIT APPLICATlON <br />of Projsct: _New _Addn �Alteration _Repalr <br />Show Number (#) of t7rtures <br />I Toilet <br />Shower <br />Kitchen sink & � <br />Pishwasher <br />Clothes washer <br />Water heater <br />5ink (service/b€ <br />Urinal <br />Drinkinq Fountain <br />Grease trap <br />Roof drains <br />Nledical Gas <br />Other: <br />Other: <br />I heraby certlry thst f havs rsad end exeminetl Ihis application �and know the �arne to De true ai,d eorrecl. All provi�jpn� pf la� and ord�n�n�as gov�ming thiM kype of work will bo comp <br />h whether apecMea hereln ar not. The grenthig of a perml! does not preoume tn givs authority to viofate or cencel the provlsion oi any other eeate or locel leve regulattng conatrucnon <br />The I am �utho�ized by the own r of ihis prope�y to perform the �,wr1c io which s plicatiori is m�de and I ppmply with the StaW ConVectors Lew 18.27 RCN1 and 296200A WAC. <br />� 1 q 5 <br />ner/Aulhorl�ed Agent Signature Date {Revisad 9/2014J <br />