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�ERMIT APPLICATIQ� <br />BUILDINGIMECHANICAUPLUMBING/SIGN/SPRINKLER/DEMOLITION <br />CiTY OF EVERETT PERMIT SERVICES <br />3200 Cedar St., Everett, WA 98201 425-257-8810 FAX 425-2b7-8857 www.everettwa.org <br />SITE ADDRESS: �► PROPERTY 7AX # PERMIT # <br />2�C3 j- 7 5'! oos��9Z �o/aovnv j�T�IU-G�� <br />LEGAL for new construction: Short Plat/subdivision Lot No: (attach copy of long legal description) <br />OWNER ��G��G�%%� f701�f%%►�� f%G/%�� PhonelE-mail �,� .�Z,�O , � Z� <br />Address�D�Qx ,�� City/Stat�P ��j��l�/T� Q ��� <br />APPLICANT:,� Owner _ Owners Agent _ Corrtractor _ ConVactors Agent _ Tenant �mus� pro�iae a ieaer m con.em trom u,e oNoar+o do �wric m aw sPeca> <br />CONTRACTOR �i✓DG�9� State Lic. #,�-�1L"��!kc �5 �v � Z c�cv g�5. ���. # <br />i tnArv i rsu�intss nAnnt CONTACT FOR PERMIT�,9�p y�l/F-L T�✓E— <br />��' " � ���� Phone/E-mail � ,� � 3.�`6 /3 — �� <br />BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK ��i00, � <br />Existing Use of Buiiding J�/�� <br />Proposed Use of Buiiding �/�/`L � <br />Buiiding type: _ Single Family _ Duplex Townhouse _ Multi-Family _ Commercial <br />Type of project: New Addition ,� Remodel Repair T.I. Siqr� Sarinkle <br />DESCRIPTlON OF WORK (addittonal space provided on the back) ; <br />� ICi � � � ca c� <br />' MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br />Type of Project: _New _Addn Alteration _Repafr Type of Project: _New _Addn _Alteratlon _Repair <br />Show Number # of fixtures Show Number # of ilxtures <br />A/C — air handlin units Toilet <br />Forced air systems Bathtub <br />Other <br />of <br />ra <br />hood <br />eration <br />Ducting <br />Other <br />/ SUPPRESSION <br />Number of Heads <br />Shower <br />Kitchen sink 8� <br />Clothes wash <br />Water heater <br />Backflow preventer (inside <br />Urinal <br />Drinking Fountain <br />Floor drain <br />Medical Gas <br />Other. <br />Other: <br />I heraby cerUry that I have read and examined this appifcatlon and know the same to be We and correcl. All provisions of laws and ordinances goveming this type oi work wiU be compi <br />with whether specified herefn or not. The granting of a permk doea not presume to give authortty to v(olate or cance! tha provision of any other state or local law regUlatlng con5trucUon <br />That I am authori by the o er of this property to peAortn the work for whkh applicatlon is made and I compy with the State Contractors Law 18,27 RCW and 298.200A WAC. <br />' i i- / � <br />Owner/Authorized Agent Signature Date (Revised 4l2015) <br />