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I'ERMIT APPL�CATIC��r <br />BUILDING/MECHANICAL/PLUMBING/SIGN/SPRI�IKLER/DEIVIOL,ITION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 Cedar St., Everett, WA 98201 425-257-8810 FAX 425-257-8857 www.ever�ettwa.org <br />SITE ADDRESS: PROPERTY TAX # PERMIT # <br />�,� G _5 Z�`� �t ._ l i����V9��''� <br />LEGAL for new construction: Short PlaUsubdivision Lot No. (attach copy of Ibng legal description) <br />OWNER f-` � 1�� �=- L�K � �J�h l Phone/E-mail `�' �.�r ' �� � .� .a N' ;,� ��p/G � � � ��r-t <br />Address �� 7 � c ;; f;t. �, ; : . . City/5tate/Zip L. , !d � ,, . , �;� ��. �,.', � < .— ` � _ <br />e. .,, .. <br />APPLICANT: Owner _ Owner's Agent _ Contractor _ Contractor�S A je�l _ Te�Bflf (must provide a leqer of consent irom the owner to dp work In ihe space) <br />NTRACTOR /-��Jor-fc_ ��rl�� <br />fB55 r��� ��� ie. � .. � (��,� <br />r��;�a =-, :. � � � ," IState Lic. # <br />1!' r <br />I LLP 1��, w..,� �' l �^ <br />���� <br />Phone/Email t� � _<. <br />itv Bus, Lic. # <br />Jd�-��( oLIOt�K-- <br />Phone/E-mail J O }-1-/�( ��) ' rr �, t:'�. R 's.;' •, • , , .. <br />BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK __=" UUZ� �-�-- r � <br />Existing Use of Building ( Z �- �� �-' �-"'' ''' "�5 ! ti c. �' i�'7� i L HEAT SOURCE: <br />Proposed Use of Building .:�" ��?'t r--' 7i' � Gas� Electric Other <br />Building type: �C 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) : � � �� �.��L � �,.�-�{.��„�,,,,,, � � � ���=��.� <br />` t� �� , i�' t; f;; ,�� � /J C w l_ C.C� � �'i. ! t`1 !., � C.� �t V?�, � n. it :'j._ ,` <br />, ,--� �� <br />pe of Project: _New _Addn _Alteration _Repair <br />Show Number (#) of fixtures <br />A/C - air handling units <br />Forced air systems <br />Gas ran <br />Clothes <br />n <br />� esoner <br />( Refrigeration <br />� Woodstove <br />I Ducting <br />� Other <br />SPRINKLER / SUPPRESSION SYSTEM <br />Number of Heads <br />PLUMBING PERMIT APPLICATI <br />of Project: _New _Addn _,Alteration _Repair <br />5how Number (#) of fixtures <br />� j Toilet <br />� � Bathtub <br />/ � Lavatory (wash basin) <br />/ � Shower <br />� � � _�k- disposa� <br />/ Dishwasher <br />Clothes washer <br />Water heater <br />! Sink (service/bar/mop/etc.) <br />Backflow preventer (inside bldc <br />Urinal <br />Drinking Fountain <br />� Floor drain <br />i Grease trap <br />� Roof drains <br />, Medical Gas <br />� Other: <br />Other: <br />I hereby certify that I have read and examined this application and know the same to be true and correct. All provisions of laws and ordinances governing ihis type of work will be complied <br />wilh whether specified herein or not. The granting 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 I am authorized by �hre owner of this property to perform the work for which applicalion is made and I comply with the State Contractors Law 1827 RCW and 296.200A WAC. <br />.��� �:'�� (p ti� <br />Owner! t ized A i ature � Date (Revised 4/2015) <br />� � �1 <br />;� <br />2� l; <br />