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PERMIT APPLICATIG�N <br />BUILDINGIMECHANICAL/P'LUNtE3iNG/SIGN/SPRINKI.ER/DEM4L.fTION <br />CITY OF EVERETT PERMIT SERViCES <br />3200 CedaT St., Everett, WA 98201 425-257-8810 FAX 425-257-8857 www.everettwa.arg <br />� D�ESS: � � ��,,,ti �� <br />for new construction: Short PlaUsu6divisin <br />� C) �-� r'1 Y1 oU r�► <br />Address <br />APPLICANT: Owner <br />CONTRACTOR <br />Address � (�, d f <br />Owner's Ayent <br />PhonelE-mail <br />City75tateiZip <br />Contractor _ Contraclor's Agent <br />BUILL}ING PERMIT APPLICATIdN <br />State i.ic. # ( <br />V� <br />CONTACT F <br />`�IC�oc�a� oa R T - 2 <br />No._ {atiach copy ot long iegal descriptionj <br />� <br />�TEftani (mus: proviCo n le!tar ot consr..nt hbm Ihy csx�,rn i:: Go w�rk c� :f�e sn�.e) <br />, i� ���y g��s �,� � d� a a o <br />ionelEmail `d�p ' p� � D ' � �i�7 <br />; PERMIT p„1 r'rit t �.-'►�.•v�.G-'�'1 <br />i G� YY11-C.OJ, <br />�RicE oF wc�R�c <br />Existing Use of Building � �— �'�-� �T._,_ �= <br />Proposed Use of Buif q� _ <br />Building type: _✓ Single Family _ Duplex _Townhouse ,._ Mu(ti-F mily _ Commercief <br />T e of ro�ect: New AddiCion Remodel Rz air T.I. 9i n S rinkle <br />DE CRiPTiON OF WORK (ada,t;n / space prpvided on tha Uack) : <br />0. f .� -C-� f ._`�-�-'� V�-L� "t t7� � +� ►'�.A C ,�.. <br />MECHANICAL PERMIT APPLIGATION <br />Type of Project: _New _Addn �Alteration _itepair <br />Show Number tl) af Iixtures <br />A!C -- air handiinp units <br />Gas piping <br />Water heafer <br />Gas range <br />Ciothes drye <br />Rarige hoad <br />Exh;�ustfan <br />F'�Bc3� DUF71A <br />Bailer <br />! Other <br />SPRINKLER ! SUPPRESSION SYSTEM <br />Number af Noads <br />T <br />Other <br />PLUMBING PERMIT APPLICATION <br />Type of Project: _New _Addn �Alteration _Repair <br />Show Mumber (tt) ol fixtures <br />� TpilEi <br />� BathCub <br />( I avat�rv fwash basinl <br />Shower <br />Kitchen sink & c <br />Qishwasher <br />CI€�thes washer <br />bVater heater <br />Urinai <br />�loar drain <br />Grease trap <br />Roof drains <br />Medical Gas <br />Other: <br />Othor: <br />in <br />I hereby cnrtify lhat 1 havn read and exem;n�tl fh�s applfcafian and know the samt� [0 6e lrue and correct. All �rovlsions ol laws antl o�dmanc�, �ovcsm�ny Ihis typ� o( work w:li 6c ccnrp <br />w h whelh€r Sper.ifir.tl helem or not, Tha gr0nting o` a panriii doe5 not presume to yive oulhonty !a vlolate or cancel the provision o( any nthar stale: i�r lor,al IAw rguletiny curr:i� cc!:.�n <br />Tha I am aulhorir.ad by !he o�•m �r oi ihi& p�operty lo porf�rm Ihe wark for whla applicaf is made and 1 comply wilh the State Contraptors Law t8.27 P2CW and 296.200� W�1�,. <br />� - o g 1� <br />nerlAuthorized Agent Signature Da e (Revrsed 9I201-t� <br />