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I��G'�.�0�' ��'f�LQ� �,`��C�� <br /> [��S��IR��/���C���O���./�����1��/�I��/���9�����/��G��N�A`���� <br /> � CITY OF EVERE7T P�I�M1T SIERVICES <br /> 3200 Cedar St., �verett, WA 98201 425-257-$810 FAX 425-257-8857 www.everettwa.org <br /> SITE ADDRESS: � PROPERTY TAX# PERMIT# �OD� <br /> - � � ,, .rZc� S - <br /> L�GAL for new construction; Short PlaUsubdivision Lot No, (attach copy of Ibng legal description) <br /> OWNER 3c.`- � /, Q� PhonelE-mail � '� � - <br /> Address City/State/Zip C� ._ �VE' � �-t C <br /> AFPLICANT: Owner _Owner's Agent ,_,Contractor _Contractor�s Age�t _Teflaflt(must provida a Ie4er of consent from Ihe owner lo dp work In Ihe space) <br /> CONTRACTOR State Lic,# City Bus, l.ic.# <br /> Address Phone/Email <br /> CONTACT FOR PERMIT <br /> Phone/E-mail � <br /> BUILDING PERMIT APPLICATION cotvTw�cT PRicE oF woRK <br /> Existing Use of Bullding HEAT SOURCE: <br /> Proposed Use of Building �as_ Electric other <br /> Building type; ,�t Single Family _Duplex_Townhouse _Multi-Family �Commercial <br /> Type of project: _New _Addition _Remodel _Repair._T.I._Sign_Sprinkler_Demolition_Change of Use <br /> DESC RIPTION OF WORK(additional space provided on the back): <br /> � _� a <br /> �°d�5��1i��'i {�' ��j'�� ,�✓�;;%� �?�-r�� � <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type of Project: _New_Addn _Alteration,_Repair Type of Project: _,New_Addn �,Alteration_Repair <br /> Show Number(#)of fixtures Show Number(#)of fxtures <br /> A/C—air handling units Toilet <br /> Forced air systems Bathtub <br /> Gas piping Lavatory(wash basin). <br /> Water heater Shower <br /> Gas fireplace Kitchen sink&disposal <br /> Gas range Dishwasher <br /> Clothes dryer Clothes washer <br /> Range hood Water heater <br /> � Exhaust fan ' Sink(service/bar/mop/etc.) <br /> Heat pump Backflow preventer(inside bldg) <br /> Unit heater llrinal - <br /> � Boiler Drinking Fountain <br /> Refrigeration Floor drain <br /> Woodstove Grease trap <br /> J Ducting � Roof drains <br /> � Othef Medical Gas <br /> SPRIRd�l�Ep$ /SU�P�2�SSIOFd �X���NI Other: . <br /> Number of Heads Other: <br /> I hereby certify thal I have read and examined this applfcation and know ihe same to be true and correcL All provis(ons of laws and ordinances governing this lype of work will be complied <br /> wiih whether specified herein or not.The graniing of a pe�mit does not presume to give authority{o violate or cancei ihe provision of any other siaie or local law regulating consiruclion <br /> That I am authorized by ihe owner of this property to perform the work forwhich application is made and I comply with ihe Siate Contractors Law 1827 RCW and 296.20�A WAC. <br /> . � <br /> ��// � � � Date (Revised 4/2095) <br /> Owner/Authorized Agent Signature � j <br /> - ��cc�� C � � � — `�d �,(_un. <br /> �' ��ce (C �- se�� <br />