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����.r��� ��������� � <br />�uo��������������������������s�������o�►������������rwo� <br />CITY OF EVERETT PERNIIl' SERVICES <br />3200 Cedar St., �verett, WA 98201 425-257-8810 FAX 425-257-8857 www.everettwa.org <br />TAX # <br /># <br />�-/�-3 f /Z��,�,���.- � �� ,.-r, �-rr ��,�c 3 I � � ;i `�v,. ; . ,, c Jv� <br />L�GAL for new construction: Short PlaUsubdivision Lot No. (attach copy of Ibng legal description) <br />OWNER ' Phone/E-mail <br />Address L� j C—�(/� City/State/Zip ^��,� <br />APPLICANT: _ Owner �Owner's Agent _ Contractor _ Contractor's Agent _ Tenant �m�st Proviae a ieuer ot �onsan� trom me owner to aP woric in �he spa�e) <br />CONTRACTOR State Lic. #�C�G L/.� /�,Q ��S7 City Bus. Lic. # C'S �f 7/� <br />ress f-F-// N�I.�L� � <br />Phone/Email LjL h - <br />��e (,��Q ��J re SS (� Phone/E-mail � J � �^ <br />BUI�.DING PERMIT APPLICATION cONTRACT PRICE OF WORK _ <br />Existing Use of Bullding ��� - <br />Proposed Use of Building S�G�!'� Gas_ <br />Building type: � Single Family _ Duplex _Townhouse ,_ Multi-Family _�Commercial <br />Type of project: New _ Addition _ Remodel _ Repair _ T.I. _ Sign _Sprinkler,_Dei <br />DESCRIPTION OF WORK (additional space provlded on th k): <br />�- ��, �� /l ����-�� � <br />e �� ��� ��x�Tv;�e 5 <br />MECHANICAL PERMIT APPLIGA7 <br />Type of Project: _New _Addn _Alteration _Repair <br />Show Num6er (#) of fixfures <br />A/C - air handling units <br />Forced air systems <br />� uas nrepiace <br />Gas range <br />Clothes dryer <br />Range hood <br />Exhaust fan <br />Heat pump <br />Unit heater <br />I Boiler <br />HEAT SOURCE: <br />of Use <br />PLUMBING PERMIT APPLIGA71 <br />Type of Project: _,New _Addn Iteration _.Repair <br />5how Number (#) of �xtures <br />Toilet <br />Bathtub <br />Kitchen smK r� aisp <br />Dishwasher ' <br />Clothes washer <br />Water heater <br />Sink (service/bar/m <br />Backflow preventer <br />Urinal <br />Drinking Fountain <br />Floor drain <br />Grease trap <br />! Other � Medical Gas <br />SPRIIi9�CLER / SUPPRESSIOPd SYSTEfIII f Other: �p , <br />Number of Heads 2� Other: <br />I hereby certify that I have read and examined this application and know the same io be true and correct. All provislons of laws and ordinances governing this fype of work will be complied <br />wilh whether specified hereinl�r t. The granting of a permit does not presume io give authority to violate or cancel ihe provision of any other state or local law regulaiing construclion <br />That I am aulhorized by the ovar r� this property io perform the work for which application is made and I comply with the State Contractors Law 18.27 RCW and 296.20oA WAC. <br />= ;" � - �%/l%/� <br />� �� �f,----� � nata (Revised 4/2015) <br />