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•����o -►�� ���������� <br />��11�.�IN�IG���C��G�O���/��.���1��/�I��/���8�����/��G���,O`�I�� <br />'� CITY OF EVEREl'T PERiVIII' SE}�V10ES <br />3200 Cedar St., �verett, WA 98201 A�25-257-8810 FAX 425-257-8857 www.everettwa.Qrg <br />SITE ADDRESS: � � PROPERTYTAX # <br />PERMIT # <br />(� :�. / :�. �C�. �� �E'S /,� �`�', 5 C C% �`' `� �f 5 U CY} � � % l % o O {�1 i � I I ' (.�� <br />L�GAL, for new construction: Short Plat/subdivision Lot No. (attach copy of Ibng legal description) <br />.� , � i'Yl R r--t� f f�i.�-�1 s� ��'iZS'i7 ,�LJ�'Y7 <br />OWNER ! � � Phone/E-mail <br />Addfess „� �— (�-C.c.� � S •� . � "f— Gity/State/Zip � vL l�� � L� � �" � �� <br />AFPLICANT: � Owner _ Owner's Agent _ Cont�actor _ ContfaCtor's Age�t _ Tenant �must provida a letler of cp�senf from the owner to dp work In ihe space) <br />� �� � C o���:; ,� l�''ti` c�rll L�- v <br />CONTRACTOR � V:�, �`` ,r �•, ` State Lic, # I�03 Cit Sus. L.ic. # <br />�/� <br />BUILDING PERMIT APPLICATION <br />Phone/Email <br />PRICE OF <br />Existing Use �f Bullding � <br />Froposed Use of Building <br />Building type; � Single Family _ Duplex _Townhouse _ Multi-Family _ Commercial <br />Type of project: _ New _ Addition _ Remodel _ Repair _ T.I. _ Sign _Sprinkier _ <br />DESCRIPTION OF WORK (additional space provided on the back): <br />�C, � X�` ,r'' �"� f� c`7 v f? T-`-���z, f r? �" �`LC, C,�'�S'�% <br />r% <br />MECHANICAL PERMIT APr��c:w � �u� <br />of Project: _New _Addn _Alteration _Repair <br />Show Number (#) of iixfures <br />A/C — air handling Units <br />Forced air systems <br />Gas piping <br />Water heater <br />Gas fireplace <br />Gas range <br />Clothes dryer <br />Range hood <br />Exhaust fan <br />Heat pump <br />—j Unit heater <br />� Boiler <br />� Refrigeration <br />� Woodstove <br />I Ducting <br />� Other <br />Sl'RIIN�f�.ER / S�JPP9�lESSIOPd SXS�E�Ii <br />Number of Heads <br />0 <br />HEAT SOURCE: <br />of Use <br />of Project: _New _Addn ,_,Alteration _.Repair <br />Show Number (#) of fxfures <br />uisnwasner <br />Clothes washer <br />Water heater <br />Sink (seNice/badmop/et <br />Backfloiv preventer (insii <br />Urinal - <br />Drinking Fountain <br />Fiaor drain <br />Grease trap <br />Roof drains <br />Medical Gas <br />Other: �'���,(r �i <br />Other: <br />I he�eby certify that I haVe read and examined this appllcation and know ihe same fo be true and correct All provisions of laws and ordinances governing this lype of work will be complied <br />wilh whelher specified herein of not. The graniing of a pe�mit does noi presume to give authority io vlolate or cancel ihe provlslon of any other siaie o� local laW regulating consiruclion <br />That I am auihorized by ihe owner of this property to perform the work for which application is made and I comply with ihe State Conlractors Law 1827 RCW and 296,20oA WAC. <br />_ _ � �� � �s� <br />Owner/�o� AgentSignature ate (Revised4/2095) <br />' \ <br />(� � <br />