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i <br />• <br />PERIVIIT APPLICATION <br />BUILDII�GIMECHA(�ICA�/PLUMBI I�G/SIGN/SPR.II�Kl�ER/DEMOLITION <br />CiTY OF' �VER�TT P�RMtT SERVIC�S <br />3200 Cedar 5t., Evere�t, WA 98201 425-257-8810 FAX 425-257-8857 www.everettwa.org <br />APPLICATIONS AR� ACCEPTED FROM 8 AM To 4 PM <br />ITE ADDRE55: DROPERTY TAx # pERMfT # <br />�SDZ. 70 P} S�. - _ � I ��C? �, -C�� <br />�t for new construction: Short PlaUsubdivision Lot No,, (eftach copy of iang legal dascrlption) <br />ER C � � � �i� v �a�wa� "LTS . PhonelE-mail <br />APPUCANT:_Owner _purtter'sAg&nt �Contra�or _Contractor'sAflent ^Tenant(mustprovwcalottarotconsenteom�heawnmtouoworxlnthvspa�c) <br />CONTRACTOR C�' N w Cd�s-f-ru�-�o� L 8� 1 Uc. # C1 �i �� -- 01 coF aug_ ���. # �sNQ� 9/� N� <br />Address 1� J�i �1 E 14 S r~ Sz` slpor�l�� Phone/Email 2��� ��3 � S�BB <br />t� I A <br />BUILDING P�RMIY APP�ICATION <br />ne/E-mai I <br />1'RICE OF WORK �� D O �- p� <br />F�cisting Use of 8uilding HEAT 50UftCE: <br />Proposed Use of Suilding Gas __ ElectrlqT Othar� <br />Building rype' _ Stngle Famlly ,� puplax _Townhouse _, Multi-Family � Commerclal <br />T�rpa of project: _ New � Addition _ Remodel � Repair _ T,1. _ Sign Sprinkler _DemolitaonuCh�nge of Use <br />DESCRIPTION OF WOI�K (addltlonal space prov�ded on 1he baelc) : <br />--%�,� o F� 4- � � s�- � n5 r4s ��,� l�' �rd o.F c,�c� �. �, s`��,,L( o, <br />�2 �� ,�o o� w��, k�� n�.�. l� �� � n5 � a5. <br />MECI�qNICA,L PE�tMIT APPLICp`I'ION <br />rype of Pro)ect: _New_qddn Alt�ratlon __,_Repalr <br />Show Number (#) of �7xtures <br />A/C — air hsndlln units <br />Forced air systems <br />Gas pipins� <br />Gas ra <br />ciotne <br />Range <br />6chau. <br />Heat p <br />Unit h4 <br />Boiier <br />SPRINKLER / SUP�RESSION SYST�M <br />Plumber of Heads <br />P6UMBINO PEIZMIT APPLICATION <br />of Pro]ect: _Naw �ddn �4fEerat3on �Fiepalr <br />ShOw NumbAr f#) of flxtures <br />KtCh�n Si�k & <br />dishwasher <br />Clothes wasnE <br />Water heater <br />Sink (service/Y <br />Backflow prev� <br />Urinal <br />Drinking Founl <br />Fiaor drain <br />Grease trap <br />Roof tlralna <br />Medical Gas <br />Other: <br />Other: <br />I herCby Cellify tfiat I �ave reea entl exdmineq thls epplicatlon and know U10 EBme lo DB ttue end COTfHct, Aq provlsiona ot Isws and oralnen�s gpv0fnfng ihEs rype ofworlc will ba compCod <br />whh whofher speciBed hareln or not. The eran8np oT a permit tloea nol preaume to pive au17�wRy lo vialafe of cancel t►ie provisio� af any o�e� atale orlocsl tew re0ulstinp conaWCKlon <br />That I am authodzed by fhe vwner of Ihle pmpar� lo paKo� �he work for whlch eppllcatlon le made and I compy w�lt Ihe Stafe Contraciora Lew 1927 RCW anG 298.200A WAC. <br />��sr^-v r�/�iL � �����1✓ <br />OWner/AuthoYiz9d Agent Signature Date (Rev/5e0 Q�Z07Z) <br />