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09/29/2015 TUE 14:39 FAX FaBt WdtOY HOdt�Y <br />fd002/002 <br />�PERMIi A,PPLICATION <br />BUILDlNG/MECHANICAL/PI�UMBING/S1�GN/�PR.INKLER/DEMOLITION <br />CITY OF EVERETT PERM17 SERVICES <br />�� �-' <br />320� Cedar St., Everett, WA 98201 425�257-6810 FAX 425-257-8857 www,everettwa.org <br />i�9-�� <br />TE AD�R�33: � „ „ _ . .. , ,, . PRO,PEf�Tj�TA�( jf _ . - — PERMJT # - — <br />LEGAL for new constructfon� Short PIOt/9ubdlvlelon LOt No. (attach copy of long legal descrfptlon) <br />�WNER � ��% � � � Q DC� �. PhanelE-mall � �LJ — � (�� — ?j� � <br />PPLICANT: _ Owner <br />rw�,croR <br />� c5 CltylSlatelZlp �i�� � <br />Own0r9 Agent �, ContfaCCof _ COfI[�aCIOPS �ertt _ Tenant (musl prowue a letler of coneern from I�e awner lo do wcrk �n Inv <br />- 1` Yr-� State Llc. # �/l{IA� � 1.3�.Cit Bus. Lic. � <br />��i �'K�11� � �C-� �,1/ O( ( PhoneJEmall o�J��ll��j iM 1� 'l� <br />CONTACT FOR PERMIT <br />� � �� L� / � <br />BUILDING PERMIT APPLICATION <br />PRICE OF WORK <br />Existing Use af Building � <br />Proposed Use of Bufldin <br />Bullding type: � Singl� Family „ Duplox _Townhouse � Multi-Family �, Commercl�l <br />Type of proJect: New Additian Ramodol „�� Repalr T.I. SiQn Sprinkle <br />DESCRf PTION OF WORK (addltlonal spaca provlded o� ihe back) : <br />��em. �/V� p l a c�, S W a�,�e�r <br />� <br />MECHANICqL p�RMIT APPLICATION <br />ef ProJact: _New �dd� _fllteratlon Repalr <br />Show Numbar of tlxtures <br />A/C -- alr handlin units <br />Forceci alr e sfems <br />Gas i In <br />Water haatar <br />Gas flre lace <br />Gas ran e <br />Clothes drVer <br />urnt neater <br />goiler <br />Refrigeration <br />Woodstove <br />Duotfng <br />Oiher <br />/ SUPPRESSION <br />Number of Heads <br />� - � E: v <br />� 32�t <br />NEAT SOURG�: <br />� Electrlc Other <br />molltlon Chan�e of Use <br />V l!l_�� Y <br />PLUMBIN� PERMIT APPLICATIQN <br />of Projeat: _New �Addn _Altorallen _Repair <br />SHawNurr�bor # oFflxlures <br />I 7oilet <br />Bethtub � <br />5hower <br />gr <br />Urfnal <br />Drinkln�j Fountaln <br />Floor draln <br />Gr�ase frap <br />Roof drains <br />Medlcal Gas <br />Other: <br />Inside bf <br />I hereby cetilfy thet 1 heva resd ana exeminea tnfs applioAUon and knOW lhe same to be trua end conect- All pr0�islona o� iaws ahd onilnancae governing lhle type oP work wl�( bg Comp <br />wlth whether apeclFled hereln or n0t. The p�'a�lfng of a parmll daea not preaume lo glve authorlly tp VIOla�ts of Ce�no�� llte Orovfelon of eny oiher etate or locel law r@gVlgling COn3t�uolfOfl <br />Th9t I em aulhorized hy tn9 Owne� 0� Ihl3 prop�rty lo pertorm lhe work For whlch appllcalfon le made and I oomply with lhe Staie Contractore Law 18.27 17CW and 286.200A WAG. <br />r , <br />nt signature ' Dete (Rev�sed 4/2095) <br />