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� <br />• <br />PERMIT APPLIC,ATI�� <br />�UILDING/MECHANICAL/PLUMBINC/SIGN/SPRINKLER/DEMOLITION <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 ADDRESS: <br />q�S4� �5�-t�izo <br />LEGAL for new construction: Short PlaUsubdivis <br />OWNER � }.{-(p.I S—t'1�1 Y�O CH <br />��. IPR000 53y i oao� �ta:c�I yj R�n �� �- <br />Lot No. (attach copy of Ibng legal description) <br />PhonelE-mail `-j� /yj � <br />dress Q -`j�� �-�� � � 2 • �City/State/Zip �v���� , (�VA— � �ZOC.�- <br />—� <br />'PLICANT; _ Owner �Owner's Agent �'�Contractor _ Contractor�S A9efll _ TB118f1Y (must provide a leqer of conseN from the owner to dp work in the space) <br />)NTRACTUR d- JJ �'rE State Lic. #�/�� �} � City Bus. Lic. # O f q 7�7 � <br />dress'�p I � 3 /� ^J � PhonelEmail �7i./ / IS�p ��j <br />. CONTACT FOR PERMIT ���� �j.�9 ,��� <br />r--r►r� <br />BUILDING PERMIT APPLICATION <br />ione/E-mail �—(�"L�� ! [� <br />ONTRACT PRICE OF WORK <br />Existing Use of Building <br />Proposed Use of Building � <br />Building type: � Single Family _ Duplex _Townhouse _ Multi-Family _ Commercial <br />Type of project: New _ Addition _ Remodel _ Repair _ T.I. _ Sign _Sprinkler _� <br />�DESCRIPTION OF WORK (additional space provided on the back): �yUsTpt,LL f�.- �ew <br />f -r-Qa.-r Pu �t,A Sti'S7'�m.. . <br />Type of Project: _New _Addn _Alteration _Repair <br />Show Number (#) of fixtures <br />A/C — air handling units <br />Forced air svstems <br />r <br />Gas range <br />Clothes dryer <br />Range hood <br />Exhaust fan <br />Heat pump <br />Unit heater <br />Woodstove <br />Ductinq <br />SPRINKLER / SUPPRESSION SYSTEM <br />Number of Heads <br />P <br />HEAT SOURCE: <br />Electric � Other_ <br />nolition_Change of Use <br />a � �� ou�� <br />of Project: �New _Addn ____Alteration _Repair <br />Show Number (#) of fixtures <br />I Toilet <br />Shower <br />Kitchen sink & disposal <br />Dishwasher <br />Clothes washer <br />Water heater <br />Sink (service/bar/mop/etc.) <br />Backflow preventer (inside bld <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 type of work will be complied <br />with whether specifed 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 />That I am horized by the owner of this property rtorm the work for which a plicati n is made and I comply with the State Contractors Law 16.27 RCW and 296.200A WAC. <br />/� /y <br />Own uth ized Agent Signature a e (Revised 4/2015) <br />