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G��h��lfd�`� A��fl�����`Ta��; <br /> �3Y11a_.f)i�l(31f�d�G69,��ilt;�l�lF'i�lJiV1EiINGI�lGRI/:��'�IN�t 1�=F�/7���JC��_.f�i�ii)S� <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 Cedar St., [verett, WA 98?_01 425-257-8810 1=AX 425-257 8857 vrvNa.evere�wa.o�r��/S <br /> '����—�NOPER7YTAXM ��_— PEft1AlTif <br /> SITE ADURES • _ �L� O� <br /> C� fn�.d v� .��� . <br /> LHGAL for new eonslruct�on: Shnd Platlsubdivision Lot No._ (atlach copy ol lbng legal descnption) <br /> OWNER C e,r��',t�(71 I � �� � PhonelE-mail �,����[���I� _�L_�-i�- <br /> qdAiess Ciry/51ate2ip �o i ile� �f 1 I 0 v ✓� <br /> �.?q S-- - <br /> APPLICAN7�Or+ner _OwnersA9eN _Coniracler _ConlraelotsA9enl _Ten�Ml�usip-�eonia:<rctccnnomtmm�iecrcnoev�.on.i�inespa'cl <br /> CONTRACTOR (,(�N � f �,�(,�� State Lia k City Bus. Lia # <br /> � , Phonc/Email <br /> Add�ess <br /> CONTACT FOR PER�11T <br /> S�(..�' �.0 f�`�-�f%���1�-r7VC S PhonefE-mail � <br /> BUILDING PERMIT APPLICATION coNTRacT PRlce oF WORK <br /> HEAT SOURCE: <br /> Gxisting Use o(Bui;ding <br /> Gas [Icctr.c.__ Olher_ <br /> Proposed Use of Building — <br /> Bullding type: ,Single Family _Duplex_Tos+nhouse _Multi-Family _Commercial <br /> Type of project: New _Addition _Remadel _Reoair T.I._Sign_Spnnkler_Demolition_Change of Use <br /> DESC RIPTION OF WORK(add'ronal space pmvided cn fhe back): � <br /> � N�Ec.� c,oFo. �v�rN �� IS (� ER oCL � FANT a� D <br /> MECHANICAL PERMIT APPLICATION PLUMBING PEEiMIT APPLICATION <br /> TypcolProject: _New_,Addn _A��cralion_Repoir TypcolProjet�: ._New_Ad'Jn _AlteraUon�Rcpair <br /> Show Number(NJ o!fixtures Shmv NumFr;(N)o!�xfums <br /> NC-air handiinp units Todet <br /> Forced air systems �athlub <br /> G;�s pi�ing L�vatory(wash basiN <br /> Water heater Shov:er <br /> Gas fireplace Kitchen sink R disposal <br /> Olshwashcr <br /> Gas mnge Clolhes washe� <br /> Glothes dryc� LVatcn c�atcr <br /> Iiangc hood . — <br /> — Ezliaust fan _ Sink(service/bai/mup/etc_) <br /> Heat pump dackflow preventrr(inside Uldg) _ <br /> Urinal <br /> Unit hc�dcr -- — Diinking Pounlain _ <br /> 9oiler - <br /> Refrigeration f�loor drain <br /> Woodstove Grcasr.irap , <br /> � Dudinq � RoOf drains <br /> � Other _ __ L'edical Gas <br /> SPRIN4(LER 1 SUPP6tESSlOtd SYSYiEM othcr. <br /> Num6er o(Heads �� �'—_ O�he�: <br /> I hcre�y�en�ly Ihat 1 hovc rc�d�nd exam�ned tSis applicalion and know t�e snme lo he W e and correct.A�I pmvisbns af laws a^d ordinance,gaveming IAis type oI wo�k w�ll Eu comV�'�cd <br /> w.r xhclher:pecfed hwcin ot nal.i he 9ran��ng ot a perm�l dee;na14�c,ume Ia giva aWhoriry la violole o�cancel Ihe pmvisqn ol any othe�slaie o�Iocd law�cyulalin9 consUuclian <br /> Ihal I a� mdhonzed by Ihe oWnm a'th!s piopeiry b pedortn Ihe x'oik fonvAich app5wtion L^moJe and I comply wilh Ihe SIMo Conifoc�ors i.a�.v 1827 flCW anJ 2BG 200A W�C. <br /> \ � <br /> ����_/��1 ���i�� ;r.�;::�,��-���uiti� <br /> O nerlA��lhorieed Agen15i9naturc <br />