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�.?/�� 4�v%��%�•�s —�e��Cr,��G�ir, <br />PERIVIIT APPLiCAiION <br />BUILDING/MECHANICAL/PLUMBING/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 />ITE ADDRESS: �J � PROPERTY TAX q PERMIT # <br />�122 7S 5� . sw i�� ► +� (�Cr� - �l <br />LEGAL for new construction: Short PlaUsubdivisio <br />OWNER <br />PPLICANT: _ Owner _ Owner's Agent <br />NTRACTOR %(/�lL//J/✓%J fvJ, <br />ress �J03 S�iiTH /%YC'. <br />No. (attach copy of long legal description) <br />Phone/E-mail <br />Of1if8C10� _ COf7ff8CfOf S A90flt _ TBflBflt (must provide a let�er of consent from the owner to do work in lhe space) <br />te Lic. # W/�(L �O <br />Phone/Email r%j <br />N CT FOR PERMIT <br />ac ��Sr�Y' <br />ne/E-mail /' <br />Citv Bus. Lic. # <br />�LS �Sf� ��3`'9 <br />. ,. r, , <br />BUILDING �'ERMIi APPLICATIOf�I CONTRACT PRICE OF WORK (�C� <br />Existing Use of Building HEAT SOURCE: <br />Proposed Use of Building��U/�(„/� Gas Electric Other <br />Building type: Single Famil� _ Duplex _To�r.�nho�u�e Multi-Family _ Commercial <br />Type of project: New Addition Remodel �Repair T.I. Sign _Sprinkler _Demolition_Change of Use <br />DESCRIPTION OF WORK (additional space provided on the back) : <br />,Q���c ��s�� ..��i�s �-i�,� ti�w� ���-r���.�y <br />s�� r sy.sT�-� �Na � � �s <br />MECHANICAL PERMIT APPLICATION <br />pe of P�oject: _New_Addn _Alteration _Repair <br />Show Number (#) of fixtures <br />A/C — air handling units <br />I Forced air systems <br />�—i Gas pipina <br />Water heater <br />Gas fireplace <br />Gas range <br />Clothes dryer <br />Range hood <br />Exhaust fan <br />Heat pump <br />Unit heater <br />Boiler <br />Refrigeration <br />Woodstove <br />� Other <br />KLER / SUPPRESSION SYSTEM <br />Number of Heads <br />PLUMBING PERMIT APPLICATION <br />Type of Project: _New _Addn _Alteration _Repair <br />Show Number (#) of fiztures <br />� Toilet <br />� Bathtub <br />I Lavatorv (wash basin) <br />Kitchen sink & dis <br />Dishwasher <br />Clothes washer <br />Water heater <br />Sink (service/bar/i <br />Backflow prevente <br />Urinal <br />Drinking Fountain <br />Floor drain <br />Grease trap <br />Roof drains <br />Medical Gas <br />Other: <br />Other: <br />I hereby certify that I have read and examined this application and know the same to be true and correct. All provisions of laws and ordinances governing this type of work will be complied <br />with whether specified herein or not. The granting of a permit does not presume to give authority to violate or cancel the provision of any other state or local law regulating construction <br />That I am authorized by the owner of this property to perform the work for which appiication is made and I comply with the State Contractors Law 78 27 RCW and 296.200A WAG �� <br />C/ <br />L' .�% v <br />Owner/Authorized Agent Signature Date (Revised 3/2013) <br />