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Jun, 5. 2014 8, 02AM� <br />��.q:�' �q,� �'�' ��'rt^ l f . <br />� �497 P, 1 <br />��� yzs"- �o� � .?3�s— k-tRlU1�i APPLICATION - <br />BUILDfNG/MECHANICAL/PLUMBING/SIGNISPRINKLER/DEMOL[TION <br />CITY OF EVERETT PERMIT S�RVICES <br />3200 Cedar St., Everett, WA 98201 425-257-8810 �AX 425-257-8857 www.everettwa.org <br />APPLIGATIONS ARE ACCEPTED FROM S AM TO 4 PM <br />SITE ADDRES3: � � PftOPERTY 7AX # P�M1T t� C <br />3 � � S`. <br />LEGA1- for new construction: Shorf Platlsu6divisian LOt N0. (8tiach copy of long legal description) <br />�WNEf2 Q/�7 �y'(,j�f0/U PhonelE-mail � 2� 3�`3 � 7/ � <br />Address 1i �/�p j y`°� SJ ,s L_. City/stalelzip � U� i� �� �� <br />APPLEC.iii�T: _ 6NRlef _ dVJflers AQe(1f _ CiOYlI�8C20f _ C.OIIIf.'�CtOf 3 fi9C�i ,��_ TPnsnt (muxt pruvWc o Icttcr ot consrnt hom inc owncr to do vrorlc in chc cpace) <br />coNTRacroR PC�O �o��� �n.. Co�,s� �&����.#k�/�oo/�Cg6`1p/�c�Ee�s.���.#osZB <br />�Qdress � � �2 7 G �' j � �iti %�' D % /LQ / � / � 2 � Phone/�mall �� � (� �. 3 ,J � d � 3`'� <br />TENANT BUSINESS NAME CONTACT FOR PERM[T <br />�Ca. / ��q �Pr.s � 0 � 2 � .r Z o 2 .� <br />Phone/E-mail �C Q �� C�j f' j7 J'T1i�! �. C 0f7'J <br />BUILDING PERMIT APPLICATION CONTf2ACT PRICE OF WORK �,�7 — <br />Fxisting Use of Building � 1`—/`7` HEAT SOURCE� <br />Proposed Use af Building_ 's��7 �as Elcetric � <br />Suilding type: t/Single Famlly _ Duplex �Townhouse _ Multi-Famify _ Commercial <br />Type Of prOjeCt: New Addition Remodel Repair T,I. 5iqn Sprinkier Demolition Ch2nqe <br />e <br />of Use <br />DESCRIPTION OF WORK (edditional space proviv�tl on (hc back) : <br />�e�s-aa�' ���� sgm-e c.��.� es.-'7`io✓7 c�s�h���/-� sh;h�G�'s� <br />MECFI�►N1CAL PERl4lfiT APPLfCAT10N <br />pf Projeat: _New _Addn _Alteration _Repair <br />Show Alumber (ttl of fi�rtures <br />Gas piping <br />Water heater <br />Gas fireplace <br />Gas ranae <br />SPR�NfiL <br />Units <br />ION SYSTEM <br />PLUMBING PERMIT AFPI�lCATfON <br />of Pro)sct: `New �ddn _nite►ation _Repair <br />Snow Number {fy ol flxtures <br />{ Toilet <br />� Bathtub <br />Shawer <br />Kitchen sink & <br />DiShwash6r <br />Sirtk (ser <br />6ackflaw <br />Urinal <br />Floor dfairl <br />Grease trap <br />Roof drains <br />Medical Gas <br />Other: <br />Other= <br />I hereby csrtify that I have rr.,,d ��d cxamin�d this �ppficaGo�i anu know tlre asme to De irue and rnrrecL All provlslons of laws and ordinancc; 9ovsming thi; typc ofwork wi11 bc complieQ <br />w;ih whelher apeclfled hereln or not. The grantin9 of a pcRni� docs no� prezumr. to givr. aulhorily lo viol:,fe or cancel llre provi;ion of sny other etsie or local tew regulatfng const�vction <br />That I am author'vr.d by the owner c,i this praperty to pertorm the work for whbh application 1s made and I comply �th (he Statc Co�tr.�rtor. L�w t�I,27 RCW snd 298.2ooA WAc. <br />OWnCrlAuthol'lzed �lgent Signature � `Dalc� V / � (Rgvised �/2012) <br />