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OCT/26/2016/WED 03;37 PM <br />North Cree� �oofing <br />� <br />FAX No,425 487 6524 <br />� <br />PER1111lT APPL1CATtON <br />p, 002 <br />BUILDINGiMEcHAN�CAL/PLUMBINGr5l�nl�sPRinIK��RJD�MOLITION <br />CITY O� EVER�TT PERMIT SERVICES <br />3200 Cedar St., Everett, WA 98201 425-257-8810 FAX 425-257-8857 www_everetfwa_org <br />APPLfCATIONS ARE ACCEPiED FROIIII $ AM ''r'Q 4 PM <br />!TE ADDRESS: PROPERTYTAX# P I # <br />�Z�-1 b i �u.�'�-a,� � � �,1��.���Q� '� �¢ � D' 0 �'� <br />L�GAL for new const�uction: Short PlaUsubdivision �ot No.� (attaoh copy of long legal description) <br />OWNER VJla/\�� �.��.�i�1� Phone/E-maii '"\�i�'cl��� ��[�i��c� <br />a.aaress L--� v� ��,�y� 5� �City/5kate/zip <br />APP�ICAN"f: _ Ovrner Owner`s Agent � Contractor _ ContracUor's Agant � <br />CONTRACTOR N O� � V� �,�(',QtL�E..._ �J.��`�—Q ,�� L& I Lic. # <br />�d�e5s\�(��n �Z��C�(�.c_.�.1��c�a�--�-r _W��`�t��k. <br />BUiLDING PERMIT APPLICQT[ON <br />ExisYing Use of BuiEding <br />� <br />_ TenaRf (musi D�Nds a letter or �nsenl Rom IRe owner lo do vrork in the �ace) <br />0�- �� coE aus. ��o. � ,63Z��t ( <br />Phane/Emaif �ZS-�� ��� �`� � lp <br />OR P�RMIT �.�S �C � �R�- <br />�f ZS �'--t_ �c 3 -- �t g � <br />PRIC� OF WORK I.O. h�`�' �� <br />50URCE: <br />Proposed Use oF Buildin9 � Gas Electric <br />Building Eype: �Singte Family _ Duplex,,,,,,�Townhouse _ MUltl-FamlEy _ Commercial <br />Type of project; New Addition F2emodel _ Repair T.i. 5iqn 5prinkler Demolition Chang <br />DESCR[PTION OF WORK (adtliciona! space provided on thB pack}: <br />�-L�.+(' �O� �p � D a�;�� Y IZ���,1C, ��,�A��D-Q�, YW�.�•� LOW�-� . <br />_� <br />Other <br />e of Use <br />�� <br />MECHANiCAL p�RMiT APPi.[CATi�N PLU�IIlg11�G PER�{A�T APPLICAT[Ot� <br />Type of F'rojact; _New_Addn qlEeration _Repel� <br />Show Number (#) of flxiuras <br />� _ A/C — air handling units <br />�orced air s sterns <br />Gas plping <br />Water hsater <br />� Gas fireplace <br />� C�as range <br />� Glothas dryef <br />I Ranqe hood <br />� unit neater <br />—� eoi€er <br />Refrigeration <br />� � WOOdStOV@ <br />Cluctjnq <br />Other <br />SFRINi(LER / SUPP}�ESSION SYST�M <br />� Number of 1 feads <br />oFProject; _New_Addn �lEerat;on�j2epafr <br />Show Numbar (�J of �Ixturas <br />I Tailet <br />Shower <br />Kitchen sink & c <br />Dishwasher <br />C�othes washer <br />Water heater <br />Baekflow prE <br />Llrinal <br />Drinking Fou <br />�Floor drain <br />�rease trap <br />RaoF dra+ns <br />Medical Gas <br />Other: <br />Other: <br />i hereDy certtty [het I have rsad end sxamined this applfcaoon ano know the same to ae uue ana corcec{. AIt provisio�� of �aws and ordinances governing this [ype of work w113 De comp6ea <br />wltn whethar specified hersin or nat. Ths gran fing o( a permif does not presume to glve eutnortry to vlolate or esnce� �pe pr9vision o( any othor stats or local law regulanng constructlon <br />Tnet I am aulhorizsd by th� ownsrof �ri�s praps�ty fo Ds�Form ths work forwhich applicallon Is meae ana I comply wltn (hg Siata Cvntractocs C.aW 18.27 RGW and 2a6.200A WAC. <br />� -�,�rl.� �U'�i � � Zt� l (v <br />Owner/AuEhorizetl Aga ignatur Dake (Ravised &/'i012) <br />