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425-252-1666 c.m. heating <br />10:38:12 11-20-2015 2/10 <br />• <br />�RMIT APPL1CATtON <br />BUILDING/1VlECHANICAL/PLUMBlNG/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 />TE ADDRESS: I�� � h�� �� �`_ t IPROPERTY TAX N I P�MIT�' �' <br />V(J r� 1�\� � <br />�EGAL for new constructlon: Short PlaUsuhdlvision Lot No. (altach copy of long legal desc�iptton) • <br />OWNER Phone/E-mall � ��"'�'-1 <br />Address �� (��' �,� �%�, �'j� �jW City/5iate/Zlp � � (.t <br />APPLICANT: _ Owner _ owner's Agent Contractor _ Contractar's Agent _ Tertant��muss ProY�da o iBnarm �onsencrrom u,e awr,ar m doworx m cno SPa�e� <br />CONTRACTOR State Lic. #�.iy'�1.� 7 WV City Bus. Lic. # �' <br />Addrass �,�/� (� ��� � 9��,a PhonelEmail -L�(��j� l��,�Q <br />afl <br />BUILDING PERMIT APPLICATION <br />Vyl <br />PRICE OF WORK I � � � � <br />Existing Use of Bullding � <br />Proposed Use of Building <br />Bullding type: � Single Family _ Duplex _Townhouse _ Multi-Family _ Commercial <br />Type of project: New Addition Remodel Repair T.i. 5iqn Sprinkle <br />DESCRIPTION OF WORK (additional space p�avided on the back): <br />����. 1�-- � �r�,P <br />MECHANICAL PERMIT APPLICATION <br />Type of ProJnct: _New _Addn _ <br />Show Number # of 1 <br />A/C-airh <br />Forced alr <br />Gas plpinc <br />teratlon _Ropalr <br />units <br />Gas fife face <br />Gas ran e <br />Clothes dr er <br />Ran e hood <br />Exhaust fan <br />Neat um <br />Unit heater <br />Bailer <br />Refri eration <br />Woodstove <br />Duotin <br />Other <br />SPRINKLER / SUPPRESSION SY <br />Number of Heads <br />HEAT SOURCE: <br />s � ElecMc_ Other_ <br />Demolition Chanae af Use <br />PLUMBtNG PERMIT APPLICATION <br />7ype of ProJect: _New_Addn �Iteration _Repatr <br />_ Show Number (#) of /lxtures <br />Dishwasher <br />Clothes washer <br />Water heater <br />Urinal <br />Drinking �ou <br />Floor drain <br />GTease irap <br />Roof drains <br />Medical Gas <br />Other: <br />I hereby certify lhal I have raad and examfned thle application end know tha same to 6a lrue and correct. All provfslone of laws and ordinancas govaming this type of work wil! be compl <br />with whether specified herein or not. The granting of a parmlt does not presume to give authority to violata or cancel the provision of any other stata or local lew regulating construcfion <br />Thal I am euthorized by the owner thls pro arty to partorm Iha wark forwhich applicalion Is made and I camply with lha State Contractors Lew 19.27 RCW end 298.2a0A WAC. <br />.- ; � l� <br />Owner/Authorized Agent ignature Date (Revised 9/2014) <br />� �� z <br />�5� � <br />