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PERNIIT APPLI��4T�C�N <br />BUIL[��i'+1CIMEGHANIC�►L�RLUIUtBIN�/SIGN}.��'sPRII�1KLEi21DENIt3L,ITi1UR1 <br />CITY t7F EVERETI' PERMIT S�RVICES <br />3200 Cedar St., Evere#t, WA 98201 425-257-8810 FAX 425-257-8857 www,everettw�.org <br />ADDRESS: � <br />� o � c� � c�..a. �, <br />1L tor new construction: Short PlaUsubdivision <br />ER i� 1 c ��... .#- <br />PLICANT: � O+rrner � OvJner's Agent <br />TOR <br />e <br />t... IP�E�-�-�x-�..�� ► o�� e�. I�""��� C� <br />_._._ _. �_Lat Na.��. (akEach copy df long te�at description� <br />PhonetE-maii p�} Q �, . `� . ,�`� '�`�, <br />✓�+-�''^"" GtylStatelZip <br />COf)tlBClOf ^ COtll�2CI0( 5 f\g�f1( _ T8r18f1� tmust Gruv�itlq e� If�ttQr ot consent frnm sha cwr�er to Cn worK in ths <br />State �ic. tt L�-`'t City Bus. Lic. tt (�� a <br />t��1..� l:i CS � �� PhonelEniall '�� 'O� � �S • � �ib <br />,CT FQR PERMIT Q„� �t � <br />-mail (,�.� ►^Y'1't t� <br />' BUILDtNG RERMIT QPPLICATlON CONTF2ACT PRtGE �1F WORK �.L'' U��' <br />� Existing Use af Bui(d� g HEAi 5C}URC�; ,�� <br />' Propnsed Use of ilciing _ Gas Flectr jic �Other <br />Buiiding ty�e: � Single Family � Ouplex _7awnhouse _ Mul ' amify � Cnmmercial <br />T e ot ro ect: I�tetv Additi�n Remodei Repair T.l. Si n S rinkler Demolitinn Chan e o( Use <br />DESCRIPTION 4F WORf( bt���? space �rovrct�d �n 6�re back): �� �,,,,� f7 <br />� � � � � � '� l L./�-' Y" 1-{ .S .s � v v� ► � <br />MECHANN�AL PERMIT AR�LICATION <br />Type of Pro}ect: _New _Addn _Qlteration _Repair <br />Show Number (qj o/fixtures <br />` AIC -- air handlinq uni[s <br />E Forced air systems <br />' Gas pipinq <br />i water heater <br />Gas ran;�e <br />Clothes dryer <br />Range hood <br />� Exh�aust tar� <br />E Ne�f pumP �, <br />`'� Unit heater <br />6oiter <br />; RefriGeration <br />Wuodstove <br />�uc[inq <br />01her <br />SPRINKLER / SUPPRESSIQN <br />� Number of Heads <br />- <br />PLUM�'31NG PERMIT APPLICATION <br />of f'roject: _,New Addrr �Alteratior� �R�pair <br />&haw Num6er (tl) ot fixtures <br />TQilet <br />; Bathtub <br />I Lavatorv fwash basin) <br />sink <br />Cioti�es washer <br />Wat�r h�aier <br />Sink (service/b� <br />Urinai <br />Drinking Fou <br />Floor drain <br />Greasc trap <br />�2oof drains <br />Medical G�s <br />Other: <br />�ther: <br />i hereby certpfy IIraS 1 h�v� rc�ad •and exam�necf IhVs ap{�iicat�on and kncva� the samz to be true and corceei. Ai� provisdons o� Ic�w�. and erra�rrer�ces ca�vnmmg ihis typ� oI wwrk v+�ki be cc�rnp <br />� n wksether s�ecr};e�i hAre.vn nr not. Ttae� graniint� ot a{a�+rm.t3 tinas not �presume ta pive aulnaniy fo v�.olate ar esncel the provks�on �tl any other elate csr la�;z�k ��v regulating consiruction <br />Tha i am a�.thnnzed by the ov:n r cr' this prapH�y ta peAomi th�r wnrk icx w�ach 3pplica 'on is made �nd 1 com�3y w�ttj the 54at� t�ontr�acia�s L.uvi 18.27 €dGW and 2�6.2tY�A WAC. <br />nerlAuthorizctd Agent Signature �� Dat �� (Revrsec� 9/2D14} <br />� <br />