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12/30/2p15 wEn 12:2g FAx Fa�t water Henter �002/00� <br />7E <br />PERMIi APP�.ICATIUiV <br />BUILDING/MECWANICAL/P�,UMBING/SIGIV/S�'�INKLER/DEMOLITIQN <br />CITY OF CVERETT pERMIT SERVICES ��Cj�� <br />3200 Cedar St., Everett, WA 98201 425-257�8810 FAX 425-257-8857 www.everettwa.org <br />��. <br />LEGAI� for new constructlon� Short Plat/subdlvlslon_.__ _ Lot No. (attach aopy oP IOng legel deacrl�flon) <br />OWNER T�Y v� S �1 Phone/E-mall ���j��,Q O--� O�� � <br />Addrpsa � ( � <br />APPLICANT: <br />CONTRACTOR <br />Address � ��-�f <br />_� <br />OWner ,� �wn�r's Agent <br />`- <br />ry/StatelZlp <br />— G�%� <br />ContraCtor �, Contractor's Agent _ Tenant (muei urowae a iei�er or consem rrom inm oWno� io ao wo�k In ine <br />BUILDING P�RMIT APP�ICATION <br />State Llc. # <br />�0(IT <br />1,�/�� �PhonelEmall �o <br />CONTACT FOR P�RMIT <br />� �I ��N L� <br />Phone/F-mall LF,�'�7 � �, l ,;�; <br />CONTRACT PRICE OF WORK <br />�xisting Use of Builciing � <br />Proposed Use of Bulldin �S <br />Builcling type: „� Singla Family L� Townh Multi-Family „ Commerclal <br />T e of ro ect; New Addltion l�emo I Re alr T.I. Si n 5 rinkler <br />DESCF2IPTION OF WORK {addlt/onel speca provldsd on the beck) : <br />" 1S �Clty Bue. Llc. <br />��� cM r� ;J c �+ —I-e <br />Cti-+C-�. <br />�l � (, v � <br />pu <br />HEAT SOURCC: <br />Efectr{c Other <br />)amolilion Chanao of Use <br />`�.��b �-2,� �� � C� C-±�- � �J�.�-P�' � D'1��� <br />MECHANICA�. PERMIT APPLICAT�ON <br />Typa ot Pro�act: _New „�qddn __}1lteratlon _f2ap�lr <br />Show Number (�) of flxtures <br />A/C — air handling units <br />Forced alr systoms <br />Gas plpinc� " <br />Water heefer <br />Clothes dry <br />Range hoo <br />Exhaust Far <br />Heat pump <br />Unit heater <br />Bviler <br />Woodstp� <br />Ductin <br />Other <br />SPRINKLER i supp <br />umber of Heads <br />SYSTE M <br />pLUMBIN(; PERMIT APP�IC4TION <br />of project: _N�w _Addn �Itaratlon _Repalr <br />Sho W Number (#) of ffxlures i <br />B <br />Lavatory (wa5h basin <br />Shower <br />Kftchen elnk & dl ,� <br />Dishwaeher <br />Clolhes wa ar <br />Drfnking F� <br />Floor drafn <br />Greaso trs <br />Medlcal Gas <br />Other: <br />Other: <br />I hnYeby certl(y lha! I have reed antl Bxatnl�oU Ihls eppllcellon and know the gamm to be lrue end carrect. qll p�oVlslons oF lawa end ordlnencea govern�ng IItIS lype o� Wo�k WIII be comp <br />wlltt whelher epeclffed her0�n of not, The prenllnp of e parmll dobs not pYesume to g{va eukhorlty lp vl0�dte Ot cancel the provlefon of any olh9r 9f�t�s of fooal law regulatln0 conetrucllOn <br />Thel I am euthprizad oy the oWnar oF thle property lo perform u�e wo�lc for wlllah appllceUon la m0da and I Oompfy wllh Ihe 3tato Conlracto�5 �GW 19,27 RCW and 2fd6.200A WAC. <br />` �� () V� �� <br />Owner/Authorized Agent 61g ature Date (Revised 4/2015) <br />