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���.I�I`�' AP��,����9��� <br /> �UI��IN�/IVIE��A�1��4�/PLl���ING/SI�I�/S�RIR�I��.ERI�����ITIO� <br /> � CITY �F EVERETT PERMIT SERVICES <br /> 3200 Cedar St., �verett, WA 98201 425-257-8810 FAX 425-257-8857 www.everettwa.org <br /> SITE ADDRESS: PROPERIY TAX# ERMIT# <br /> ,_.� ����:� �!, _ j ,J ,� . '�����-01 <br /> LEGAL for new construction, Short PlaUsubdivision Lot No. (attach copy of Ibng legal description) <br /> OWNER �T / � � Phone/E-mail <br /> r�� l . /1 <br /> Address � �; v� ^f� City/State/Zip <br /> APPLICANT: Owner _Owner's Agent _Contractor _Contractor's Agent _Tenant(must provida a leuer or consent from�ne owner to dP work In the spa�e) <br /> CONTRACTOR � � L�, , � i 1 `' State Lic.# City Sus, l.ic.# �N ����� <br /> � �j ?;�C't.� � i-,� h f-'/v;,-r h� •�i 't, �`�'l�j� ( < < G'�'� � <br /> Address`5�' � )G •f`t �`S, � � ;�,�;�-c C' Phone/�mail S � <br /> CONTACT FqR PERMIT <br /> �/�i.'"i' �/ ,r�7�; °,r;r �S . <br /> Phone/E-maii <br /> BUILDING PERMIT APPLICATION coNTwacr PRICE oF woRK <br /> Existing Use of Building � HEAT SOURCE: <br /> Proposed Use of Building Gas_ Electric Other <br /> Building type; ^Single Family _Duplex_Townhouse _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 /> < <br /> ��l� `l�U�l���v� 1� � G�G��-�-� �t��lS��.� <br /> I <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type of Project: _New_Addn _Alteration_Repair Type of Project: _New_Addn ,_,Alteration�Repair <br /> Show Number(#)of fixfures Show Number(#)of fixtures <br /> A/C—air handling units Toilet <br /> Forced air systems Bathtub <br /> Gas piping Lavatory(wash basin). <br /> Water heater Shower <br /> Gas fireplace Kitchen sink&disposal <br /> Gas range Dishwasher <br /> Clothes dryer Clothes washer <br /> Range hood Water heater <br /> Exhaust fan ' Sink(service/bar/mop/etc,) <br /> Heat pump Backflow preventer(inside bldg) <br /> Unit heater Urinal - <br /> Boiler Drinking Fountain <br /> Refrigeration Floor drain <br /> Woodstove Grease trap <br /> I Ducting J Roof drains <br /> � Other Medical Gas <br /> SPRIM�'CLER / SUPPRESSIOfd SYSTEM Other: <br /> Number of Heads Other, <br /> I hereby certify that I have read and examined this appllcation and know the same to be irue and correct.All provisions of laws and ordinances governing lhis type of work will be complied <br /> wiih whelher specified herein or not,The granting of a permit does noi presume to give authority io violate or cancel ihe provision of any other siate or local law regulating conslruction <br /> That I am auihorized by ihe owner of this property to perform the work for which application is made and I comply with ihe State Contraciors Law 1827 RCW and 296.200A WAC. <br /> �/ � �/ f L <br /> r�� � Date /� (Revised 4/2075) <br /> qy� uth ed A nt Sig a re `' <br />