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0 <br />.7 <br />• <br />RMIT APPLICATION <br />"`'� BUILDING/MECHANICAL/PLUMBINGISIGN/SPRINKLERfDEMOLITION <br />CiTY OF EVERETT PERMIT SERVICES <br />3200 Cedar St., Everett, WA 98201 425-257-8810 FAX 425-257-8857 www.everettwa.org <br />ADDRESS: <br />.. ..'S E 1 C�t i I� � c <br />TAX # <br />for new construction: Short PlaVsubdivision Lot No. (attach copy of long legal descriptfon) <br />� Cr-� A(ZD �' �I i C <br />C.1C �Phone/E-mail L�Z�J - c� ZZ -3'��1� I CI(lf'I I <br />� <br />c.'.: Y�c�. L ct; <br />Z- �1 �3 H o� t��' � ICitylState/ZiP � v� TT, l�=�A `�8'L�='� <br />�T: � Owner _ Owner's Agent �Eontractor _ Contracto��S A j211i ,_ T8t18f1t (must provide a letter of consent from the awner ta do �wrk in the space) <br />f�/ P <br />BUILDlNG PERMIT APPLICATION <br />> <br />',iv� (�L �� State �ic. # ` c� � A ►h �= L ��� �' � 1�ity Bus. LiC. # (� �� <br />� �Phone/Email <br />�R PERMIT �1i L��" � �i��l� <br />" J��� �� LhCI l.%`Cac,�. L C:�YYtCti �• L D;'�-� <br />PRICE OF WORK <br />Existing Use of Building '��'°�1�1�yy� -.`�,�s�� �'i�c�Yi�li,q HEAT URCE: ,' <br />s <br />Proposed Use of Building,��`.�►C1 ��'�L " �� \Ir �c���' ��+ Gas ' � ��Electric �'� Other <br />Building rype: X Single Family T Duplex _Townhouse _ Multi-Farnily _ Commercial <br />Type of project: _ New _ Addition X� Rembdel � Repair T.I. _ Sign iSprinkler _DemolitioniChange of Use <br />DESCRIPTION OF WORK (additional space provided on the backJ : IZ �i'Y1c�V ��3 Q> -('�,t,r •r�c: �, � �rc: � ICiC c? t;.%%G�t.�c�-�-1�>^� <br />�� c�cit-� r�, S�j`'�j-Crn (�l c c-r-rti c t�-\ �. PCYYt.C.t��i �Xts-ti v�cJ bGti`1'h.►�c'N b� �ni��.o-� : v� S►'u'�.0 x�. <br />'MO�:� V'it�1�� ��iVik/ba#'Lt+'tctn c+�c�c`>r. �plCu� vn� .`�6�'t.k, �t11 CJiti,�r t.�Pi��r�tc��� <br />-Fi x-h,��,; ca��r�� bctci�- e�.� ��x.�sfi � I��rn.b,v�c ' �1er-t��,uu c�c..����6. --> d�E� 7 <br />MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br />of Pro)ect: �New,YAddn _Alteratton _Repair <br />Show Number (�t) of /Ixtures <br />�j- �{ ' A/C — air• handiing units <br />� 1 Forced air svstems <br />Gas rar <br />Clothes <br />Heat pump <br />Unit heater <br />Other <br />Number of Heads <br />ot Project: _New _Addn ,�,Alteratlon �Repair <br />Show Number (#) of ffxtures <br />1 Toilet <br />Kitchen sink 8� c <br />Dishwasher <br />Clothes washer <br />Urinal <br />Floor drain <br />Grease trap <br />Roof drains <br />Medical Gas <br />Other: `-a � <br />Other: <br />I hereby certify that I have read and examined this applicaUon and know the same to be true and correct. All provisions of laws and ordinances governing this type of work will be comp <br />with whether cified herein or not. The granGng 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,l �u orized by the owner of this pro to pertorm the work for which appGCatan is made and I comply with the State Contractors Law 18.27 RCW and 296.200A WAC. <br />, <br />�,. ���, � - �� � ���� <br />Own r/Authorized Ag t tg ture Date (Revised 4/2015) <br />, � � ��, <br />