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s <br />� <br />� <br />PERMIT �.1PPLfCATJON <br />BUILDING/MECHANICAL/PLUl111BING/SIGN/S�'RINKLER/DEMOL�TION <br />CITY OF EV�RETT P�f�MiT SE12VlGES <br />3200 Cc�dar St., Everett, WA 98201 425-257-3810 1=AX q25-257_gg57 wvwv,everettwa.org <br />PERTY TAX #i PERMIT � <br />�3q3n�obD�� 01 i�n �� <br />LEGAL for new calstttiction; Short PI9Usubdlvision �p{ �a <br />(attach cnpy of long lega� descrlption) <br />'OWN�R i� r o n do� `� o� <br />Phonel�-n�al� �p( � • � <br />AdQPBss <br />city/statelZip <br />APPUCAP}I'� ,_ Owner _ pwner's Agent _ Contractor Contraclor's A ent T <br />- � _,,,, eflaltl (mus( pr0'i�0e e leNar trf conarnt from thQ 0�+'�er Uj tlo K'Ofk in Ihe spopq) <br />CONTRACTOR ��M State �ic_ # j�% Cit E3us- l,ic. � Q ot � a � <br />AddresS Q� .� �� f L� Phone/�mail `��p •a � g � � {�b <br />TENANT BU iNES3 N ME CONTACi FOR PERMIT � mt t �Y�-�1 <br />BUILDINC� P�RMlT 4PPLICOTION <br />Exis#ing Use of BUilding �� <br />Proposed Use flf B iiding Gys <br />Quilding type: �Singl� Famity _ Duplex�Townhouse � Mul '�amily � Commercial <br />� e oi ro�e�t; Now Addition Remodel Re air T.I. Si n S rinkler C <br />D� CRfPTFOFV OF WORK additionelspacs provJ on the back): <br />C�1�q �. oV� C� Q S �V t rt� �'cJ <br />�onelE-ma11 [� y'y'�'I .L� � <br />ONTRACT �'RICE DF WORK � O � <br />MECHANiCAL PERMIT 4PPLICATlON <br />of Praject: �NEw _Add11 /i Attereti0n „,_liepair <br />Sho�vNumber ll otfixtures <br />A/C w air hahdtin units <br />� Forced air svstems <br />Water heaier <br />Gas fireplace <br />Gas renge � <br />Clothes d�er <br />Rang9 hood <br />Exhaustfan <br />Neat u� mP <br />Unit h�ater <br />Other <br />3PRINKLER / SUPPf�ESS10N SYSTBM <br />SOURCE: <br />:C[ric Other <br />h Ghan�e of Use <br />RLUMBINIG PE�2M[T APPLICA <br />Type of Projctt: _hfew _qddrl _Alteratian _Repair <br />__._. Show Number (#1 o/Nxfurss <br />Shower <br />Kitchan sink & c <br />Dishwasher <br />Clo#hes washer <br />Water heater <br />Floor drain <br />Grease crap <br />RooF drains <br />Medicai Gas <br />Other, <br />in <br />r <br />N <br />I �areby Ce�l�fij thet I have resd and examinetl lhiS.ppli�tion ena Y.nnw 4h� sams to be true antl corcec1. All prav�siona of lews and oirilnsnces governrn� this �ype of work will be wmp <br />� h whet�er spec�ed hereln or naf. The �renqng of s permil doss nvt presume to give aufhonry to vlolate or cancel tha provis�on oP eny other atate or loeal law reguisting eonstr�ctipn <br />The 1 am authorized by lhe own r of 2hM pr�perry to pertorm tha � ork for w ich applfcaflon iv mads end I comply with the Ststc Co�traciors Lew 18,27 RCW and 296.200A WAC. <br />- IO 1� 5 <br />ner/Au}hp�izad Agent 5lgnatul'A DakE (Revised 9/2074) <br />