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� �S� ,�53 y � �� )�� c� �o��� C z�Z ;� :. -.� . �, ��i � <br />p��.�-� �����1 � <br />PERMiT APPLICATlON <br />BU�LQINGlMECHA(VICALIPLUMBINGISIGN/SPRIN KLER/DEMOLITiOf�f <br />CITY OF EVERETT PERMIT SERVICES <br />3200 Cedar St., Everett, WA 98201 425-257-8810 FAX 425-257-8657 www.evereriwa.org <br />APPLICATIONS Al2E ACCEPTED Fi20M 8 AM TO 4 PM <br />4DDRESS: PROPER7YTAX� PE T# <br />��i � 1 / � 5� �) S, lvi�,oT� , 6� �, ; �.i n ._ �� <br />(or new construdion: Short PlaUsubdivision <br />OWNER <br />PPLICANT: , Owner _ Owner's F�qent <br />ONTRACTOR ���1�-P .IZ . �('ti�-1-� U <br />� �,.,. , <br />No. (attach copy of long legal description) <br />Phone/E-mail <br />City/S1ate/Zip <br />Contractor _ Cor�tractors Agent _ Tertant (mus� nrotin� e io �er ar cansem rrem me owner m do work'�n cne syace) <br />L& I Lic_ # COE Bus. Lic_ # n���� <br />F•' � f`� L � i f�l �—t�' i- Phone/Email �J � (� �� % �� '7 <br />... . ��.iu�. <br />�1 C/l� A�-1� �%`'� �1 i n-a--S <br />mail ,�'��' �v7,�s �/2� �.j <br />'BUlLDING PERMIT APPk,fCAT10N CONTRACT PRfCE OF WORK <br />F�cisting Use of Building : G� <br />� / <br />Proposed Use of BuiEding � i E`� F— —�'�-��G �%7 �S�Y�� fi J Ga <br />Building type: �Sing€e Family _ Duplex_7ownhouse , Multi-Family `Commercial <br />Type of projec[: _ New _Addifion _ Remodel _ Repair T.I. Sign SQrinkler D <br />DESCREPTlON OF WORK (additional space prov�ded on the back) : <br />l�E �-n� �2�u�1����;� �-,. ��,��u> �2�:u��,u�� i,�S���i.� �- <br />��Li. 5 � �%c� rLi-< <���� '�i: v �� �� . <br />N EAT SOU RCE: <br />�lition Change of Use <br />�` � {-e �� r"4 �-t r � <br />, <br />MECNANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br />TypeofProject: _New_Addn _Alteration�Repair TypoofProject �New�Addn _A3teratiortTRepair <br />Show Number (tl) of �rz7ures Show Number (#j of rxfures <br />A!C — air handlmg units ; Toilet <br />Forced air systems Bathfub <br />� Gas piping Lavatory (wash basin) <br />ace <br />Range hood <br />Exhaust fan <br />Heat purnp <br />Unit heater <br />Boiler <br />Refrigeration <br />Woodstove <br />Other <br />LER / SUPPRESSION SYSTEM <br />I Number of Fteads <br />Kitchen sink & c <br />❑ishwasher <br />Clothes washer <br />Water heater <br />Backflow <br />Drinking F�u <br />Floor drain <br />Gtease trap <br />Roof drains <br />Medical Gas <br />Other: <br />Other: <br />I hereby certiy Ihat f have mad and examined tliis appti�tion and know U�e samr, to be hue and wrrect. Att provisions of laws and ardinances governing thls type otvrork wdl be �mp5ed <br />v+dlh whether specified herein or not. The granting of e permit does not prosurne to give authority ta vlolate or cancel tlie provaian oi any other state or Iocal law regula&ng oonstrucRon <br />iliat I arn authonzed by [�e owKier of thls prapeny to pertorm the work for whlcn applia�tion is rnade and I com�fy with the State Con[radors Law 16.27 RCW and 296.200A WAC. <br />� .�;�'/1.�. ��--t-�v�' -- � �� %,) f. � <br />OwnerlAuthorized Agent Signa ure e Date (Revised 62012) <br />�' d 9�Z L-�0�-E9Z <br />uoi�ona�suo� ueoiaai.uy d ��:ZO � 6 ZO ��O <br />