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C � � j �>� — clv� � �,o•— <br />�ERMIT' APPLIC�►TI� <br />BUILDING/MECHANICAL/PLUMBING/SIGN/SPRINKLER/DEMOL,ITION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 Cedar St., Everett, WA 98201 425-257-8810 FAX 425-257-8857 www.everettwa.org <br />'..��`�v(.�_�,�%3 <br />SITE ADDRESS: PROPERTY TAX # P�RMIT # <br />r � � �i�� �c ���3��� ✓�'�l�(� � - t � <br />�v.�.� i,u. ,.�ur��C- :°�� k j,✓z_ o.,jl;� �, a l� <br />L�GAL for new construction: Short PlaUsubdivision Lot No. (attach copy of Ibng legal description) <br />,�, ..T` < �+;.� � � .�,t"/� lyJ «c. � .. �� <br />OWNER /�%►-fe,z 1i-t �!'�.; �-fvi ts Phone/E-mail �7S .3` (;.�1-��;�; <br />Address FC� %j l:� � �'S ef City/5tate/Zip �0 v�,� f-o� /;p�,� �� � ;'� �L <br />APPLICANT: Owner _ Owner's Agent _ Contractor _ Contractor's Agent �` TBflBflt (must provida a letter of conseN from the owner to dp work In the space) <br />CONTRACTOR /�u.-54•.- ��1c:iY-ia� <br />Address /C.j"L G!/..��l�ar����- (/, �'•✓ �:... �"l�i,,r <br />State Lic. # City Bus. Lic. # <br />�� f ��.; Phone/Email °!�, � � v —C•=t+:; � � c� ✓� n �✓ � i�{, <br />I !i h t+-rt�-/ar y � <br />�t�`�� ' ����~��r� Phone/E-mail <br />BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK <br />Existing Use of Building %��K ri °� S'`/r., <br />Proposed Use of Building S«"L�- <br />Building type; ^ Single Family _ Duplex _Townhouse _ Multi-Family �` Commercial <br />Type of project: New _ Addition Remodel Repair _ T.I. _ Sign _Sprinkler <br />DESCRIPTION OF WORK {additional s ace rovided on the back)' <br />� • ,. <br />���'"'z� <br />/� O dl <br />HEAT SOURCE: <br />Gas __ Electric Other <br />e of Use <br />P P <br />, ' '.! ..� / � .S i' . (> ��r / :� �e � n" � �?' <br />�,-c ��, cY� � G��i s •� L�'r /,� �t k�� � u � `�.� c,., ,� c z �, � <br />�o�. (L-�Sz��o r'Y��'g o«�P��� _ SerJ►c� s <br />MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br />Type of Project: _New _Addn _Alteration _Repair <br />Show Numbei (#) of fixtures <br />A/C — air handling units <br />Forced air svstems <br />�as piping <br />Water heater <br />Gas fireplace <br />Unit heater <br />Boiler <br />Refrigeratic <br />SPRINKLER / SUPPRESSION <br />Number of Heads <br />Type of Project: _New _Addn _,Alteration _Repair <br />Show /Yumber (#) of fixtures <br />I Toilet <br />basin) <br />Shower <br />Kitchen sink & di: <br />Dishwasher <br />Clothes washer <br />Water heater <br />Sink (service/bar/ <br />Backflow preventE <br />Urinal <br />Drinking Fountain <br />Floor drain <br />Medical Gas <br />Other: <br />Other: <br />osal <br />r (inside <br />I hereby certify that I have read and examined this appllcation and know the same to be true and correct. All provislons of laws and ordinances governing this type of work will be complied <br />with whether specified he in or not. T 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 b h -this property to perform the work for which application is made and I comply with the State Contractors Law 18.27 RCW and 296.200A WAC. <br />, �� � ' �//� �` S <br />re <br />(Revised 4/2015) <br />�lz <br />