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PERMIT APPLICATIaN <br />BUfLDING/MECHANICAL/PLUMBING/SIGN/SPRINKLER/DEMOLITION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 Cedar St., Everett, WA 98201 425-257-8810 FAX 425-257-8857 www.everettwa.org <br />APPLICATIQNS ARE ACCEPTED FROM 8 AM TO 4 PM <br />ADDRESS: PROPERTY TAX # PERMtT # <br />l�1lD M�KKar_c G�t"Ktc -t�A�v�.��" 24�odO2oodnr��no Rl�nR �(�`�' <br />lL for new construction: Short Platisubdiv <br />ER � N.Th��'.!�-'T�?�i� �-+ «-� 1?' <br />Lot No. jaitach copy of long lega! description) <br />Phone/E-m�ii <br />City/State/Zip <br />� a� i h -'�' ee_ . <br />,�- 7�$'`� � � <br />CANT: ,� O�mer __ Owner's Agent _ Contractor _ Contractor's Agent _ Tenant pn�st pro��oe a�ene� or �o��serrt irom tl��e uwr,er to do work in ihe space) <br />: i <br />R 'T� K 11''� If'.(.1 ( C3 L{� IL & i Lic. # COE Bus. Lic. # <br />ress 1 IPhonelEmaii <br />:� r�-� e� r�,t ed � i� cl�nc l c,� i�� � -oA � v��� <br />Phone/E-mail b �� I(\,o'��yvt t� �� <br />BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK ��- S ���G'c3�� <br />Existing Use of Building r��,N��ac��-�,�c* HEAT SOURCE: <br />Proposed Use af Suilding �� Gas Eiectric other <br />Building type� Single Family _ Duplex _Townhouse _ Multi-Family !`� Commercial <br />Type of project: New � Addition Remodel Repair _ T.I. Sign __Sprinkler ,Demolition Change cf Use <br />DESCRIPTfON OF WORK (aciditional space provided on rh,e backi <br />�Ivl��e S—i-nr�� � 7�% S. �¢.i0�� 7�t Ot�l d a i-i�S� �t.\� ��`l:KUT-1�CJT��;�jy � <br />F Q.� L 1'Y`'� C"�.NT: <br />MECHANICAL PERMIT APPLICAiION <br />of Project: _New _Addn _Alteration _Repair <br />Show Number (#) of fixtures <br />A/C — air handling units <br />Forced air svstems <br />Ges piping <br />Water heater <br />Gas range <br />Clothes drye <br />Range hood <br />Exhaustfan <br />Unit heater <br />Boiler <br />Refrigeration <br />Woodstove <br />� Other <br />SPRINKLER / SUPPRESS <br />I Number of Heads <br />PLUMBING PERMIT APPLICATION <br />of Project: _New _Addn _Alteration _Repair <br />Show Number (#) of fixtures <br />I Toilet <br />Lavatory (wash basinj <br />Sho�r�er <br />Kitchen sink & disposal <br />Dishwasher <br />Clothes washer <br />Water heater <br />Sink (service/barimop/e <br />Backflov�✓ preven#er <br />Urinal <br />Drinking Fountain <br />Floor drain <br />Grease trap <br />Roof drains <br />Medical Gas <br />Other: <br />Other: <br />I hereby certify that I have read and examined this application and know the same to be true and correct All provisions of lavds and ordinances goveming this type of work will be complied <br />with �,Nhether specfiied hercin or nut 71�e granting of a pennit does not presume to give ai,ithonty to violate nr oancel the provision of any other state or local law regulatinp oonstruotion <br />�hat I sin <,u�ho�iza, r the•; �ncr uf �i � i���_�iq fi �,_�rfbir�� t i -o�k �;h���!�� ��,�li:atir,r �.�� n�i i ���, �� dh thr; State � ���ir txSl_i�;•. 1' RC�! an ��,`:,_ ._i_P. �vt�C <br />� <br />� ��� <br />Owner/Authorized Agen Signature Date fp,ev�seci b'.�201�) <br />