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r <br /> PERMIT APP'LICATIOf� <br /> BUILDING/MECHANICALIPLUMBING/SIGN/SPRINKLER/�EMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 Cedar St., Everett, WA 98201 425-257-8810 FAX 425-257-8857 www•everettwa.org <br /> PROPERTYTA%H PERMIT# <br /> SITE ADDRESS: �L — �� � <br /> � � -'`') !:J2 r.., 2,� V. . /l <br /> LEGAL for new constmction: Short PIaJs bdivision Lot No._ (attacb copy of long Iegal descdpCon) <br /> OWNER �$qGtOf SCI��-f'_ 7� PhonelE-mail <br /> Address CitylStalefZip <br /> APPLICANT: Owner Own�YsAgent Contractor _CoNraclor'sAgent �TB020�(muslpmvi0oelenero/wnsenibanl�ommertoCoworkinNaspaco) <br /> i \ Cit Bus. Lic.# <br /> CONTRACTOR i � ����� �tS��� I+`,VLL{,fti'C 1 Sla�e Lic # Y <br /> Address � ? �t-7�, �L..�« ��`��` '��" t�5��1 Phone/Email��/�i � 7�'��`�� <br /> CONTAC FOR PERMIT ^�J /1 S'u� <br /> TENPNT BUSINESS NAME + T V �� ,� C� �uy /"' G <br /> r�i .��;�,,�� <,:�.;,>,� P�,� � M <br /> PhonelE-mail � �)>)h?�- Os-=la ���)C�—U-%U3� �'ja��: �a:i�d� <br /> -7 UU t n:i.9.• c-.�(y� <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK '4" r <br /> HEAT SOURCE: <br /> Existing Use of Building <br /> Proposed Use of Building Gas_ Electric_ Olher_ <br /> Building lype: _Sing!e Family _Duplex_Townhouse _Multi-Famity _Commercial <br /> Type of projecl: _New _Addilion _Remodel _Repair_T.I._Sign_Sprinkler_De��o!f!icn_Change of Use <br /> DESCRIPTION OF WORK(addifional space provided on fhe back): <br /> ./� f''' 7�{' C,y�l{ ,\� r�nrA . <br /> �f�i.a•-.�I . 'r�/�!L�'G/'.�Fn r <br /> �dr� i wci(I, crea+c a-��ce, �tdd ba m�uNl <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Typo of ProJect: _New_Addn _Alteratlon_Ropalr Typo of ProJoct: _New_Addn _Alferation_Re�air <br /> Show Number(N)07 fixNrrs Show Number(N)o/flxtures <br /> A/C-air handling unils I Toilet <br /> � Forced air systems � Bathtub <br /> � Gas piping � Lavatory(wash basin) <br /> Water heatar � Shower <br />' 1 Gas fireplace I Kitchen sink&disposal <br /> � Gas range I Dishwasher <br /> I Clolhes dryer I Clolhes washer <br /> � Range hood � Waler healer <br /> � Exhaust fan I Sink(service/bar/mop/etc.) <br /> � Heat pump I Backflow preventer <br /> � Unit heater I Urinal <br /> � Boiler I Drinking Fountain <br /> � Refrigeration I Floor drain <br /> Woodstove I Grease trap <br /> Ducting I Roof drains <br /> � Olher � Medical Gas <br /> SPRINKLER / SUPPRESSION SYSTEM � Other: <br /> � Number of Heads � Olher. <br /> I hereby cetlify Ihat I have read nnd eaamined this applicalion end know ihe sama to bo tme ond correct.All provisions al laws end ordinances goveming Ihis lype of work will 6e complied <br /> with whether specilied herein or noL The granting ol a pertnil tloes not presume to give authorily to violale or cancel the pmvisio�ol eny other stata or local law requlating construclion <br /> 7ha11 am authorizetl hy Ihe owner ol INs propehy Io per7orm the work for whic�application Is mede and I compiy wMh the State Conlractors Law 1827 RCW antl 2?6100A WAC. <br /> I�� <br /> OwnodAuthorizod AgnnlSlgnaWm <br /> Dale (Revised 32073) <br />