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• <br />• <br />PERMIT APPLICATION <br />BUILDING/MECHANICALJPLUM�INGISIGN/SPRINKLER/DEMOLITION <br />CITY OF EVERET7 PERMtT SERVICES <br />3200 Cedar St., Everett, WA 98201 425-257-8810 FAX 425-257-8857 www.everettwa.org <br />✓1 5 W <br />TAX # <br />PERAAI7 # <br />LEGAL for new construction: Short PlaUsubdivision_� Lot No. (attach copy of lony ieyal descnption) <br />OWNER w 1 C—L (�hN1 �� �J ��( Phone/E-mail 7 �� l,1 to l wi�/i�i% �'� �� <br />Address ! T,5� City/StaleJZip ��r �l� � J L�-' <br />APPLICANT: Owner �_ Owno�s Agent __ Contractor ___ Contractor's Agent _ Tenant �m�s� aovde a wner or«�nu�m imm mP om,er co do work �n tne soace) <br />CONTRACTOR l�n\%�Yv l,C� ��! S��-�' l b 1 State Lic. J� �} c�iy sus. ���. #(� 3 <br />Adilress I L7 �V 4 I_3 w �� ^ t y� � W✓' (' ��b� J PhonelEmail L� � 1�S ^' J 1�� <br />TFNANT 6USINESS NAME CONTACT FOR PERMIT <br />BUIi.D1NG PERMIT APPLICATION <br />ZO��G7�o�� Wrc,rosb L� i�.citii•Conn <br />F'RICE OF WORK 'g'LS .a � <br />Existing Use of Building __ "��,� HEAT SOURCE: <br />Proposed Use of uilding.____ Tp �' _ G� Electric <br />8uilding type: �Single Family _ Ruplex _Townhouse ,T Muiti-Family _ Commercial <br />Type of project New Addition Remodel Repair T.I. Sign �Sprinkler _Demolition Char <br />DESCRIPTI�N OF WURK {additiona! space provided on the back} : <br />t �5-��� �,�,s -��� i ri�.��- -� -��.�s-�� ,��oa ������� w�����y <br />MECHANICAL PERMIT APPI.ICATION <br />of Project: _New �Addn LAltert <br />Show Number (#) of fufures <br />r A/C — air handiin� <br />Forced air s ster <br />Gas pi�i� <br />i Watar heaier <br />; Gas fireplace <br />Gas ranqe <br />Range hood <br />Exhaust fan <br />Unit heater <br />Boiler <br />Refrigeration <br />W oodstove <br />RINKLER / SUPPRESS <br />Number of Heads <br />�Repair <br />units <br />SYSTEM <br />Qltier <br />of Use <br />� •1 <br />PLUMBING PERMIT APPLtCAT10N <br />of Project: _New _Addn __._Atteration _Repair <br />Show Number (#) of fia7ures <br />! Toilet <br />Bathtub <br />� Lavatorv (wash basin) <br />Kitchen sink & <br />Qishwasher <br />Clothes washe <br />Water heater <br />Urinal <br />Roof drains <br />Medical Gas <br />Other: <br />I herehy certity that I have read and ezamined [his application and know the sarne to be hue and correcl. All provisions of laws and ordinances yoveming this type of work will 6e comp <br />with whelher specified herein or noL The yranting of a pertnit dces not presume to give authority to violate or cancel lhe provision of any other slate or loc:al law regulaGng construction <br />Thal I• a tho ' etl by the wner o[ 's prope to perfortn the,work for which application is maae and I cornply wi�h Oie State Contraclors Law 18.27 RGW and 296.1WA WAC. <br />� r 1 <br />� <br />Owner! thorized Ag nt Signature a e (Revised 9/20�4} <br />