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! • <br /> PERMIT APPLICATION <br /> BUI�DING/MECHANICALlPLUMBIPJG/SIGN/SPRINKLER/DEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 Cedar St., Everett, WA 98201 425-257-3810 FAX �25-257-8857 �vv✓w everettwa org <br /> C�- ��-I �( <br /> S'7El�DDRESS: ( 1-�Q sC �JG✓L-�-�- �•lk�I �(� PROPERTYTAKq PERIv11 d <br /> L <br /> LEGAL for ne�v constrcction Short PlaUsuDdivision Lol No faltach copy ol long le9al descriplion) <br /> OWNER PhonelE�ma�l <br /> f•ddress Cdy�Slale�Z�p <br /> APPLICANT: _Owner _O�.vneisAgent _Conl�aelor _ConlraclorsAyenl _Tenant�m�;icw.c�.,:rn:,m«.���:ec�-.ro�.��:iom,.�:a�-.�.rn�,;,�..��� <br /> CONTRACTOR ��� 1���'�q��G"1 `� /tC State Lic. # 55M�� �: � 9D3d A City B��s. Lia# <br /> P7d�ess 5� � � ��t��"1V 1��rLl�/`U PhonelEma�l <br /> TENANT BUSINESS NAFdE CONTACT FOR PERMIT �e�,�' y�/�J v rG-� <br /> T., 4��0. �I`{� '370 -�7�91i <br /> � j�C PhonelE�ma�l S�{F �Nl�✓1>'�'� (e1�'i+• nS, C o r.� <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WURK `�`���00 __ <br /> [xisting U=_e of�uJtlmg �MIwJCi�,� HEAT SOURCE- <br /> Proposed Use of Builtlmg '-'�� ^'�< Gas_ Electric_ Olher ___ <br /> Budding type� Sicgle Family _DupL x_Townhouse _ A7ulli-Family _Commercial <br /> Type of prrlect New Adtltlion Remodel _ Repair_�T I __Sign_Sprinkler_Demolition_Change of Use <br /> DESCRIPTION OF WORK(aed�nonai space pw��ded on rne bacal. , <br /> �emodt ( o-F CK�St,..�� � rc55�n� �oo� ci.nu �;�d�n•� I-,ec✓���y ��fcr <br /> �O o r� <br /> MECHANICAL PERMIT APPLICATION PLtiMBiNG PERMIT APPUCATION <br /> TypeolProjecC __NeH_Addn _Alleralion_Repair TypeolProject: _New_Addn _Alteration_Repair <br /> Show flumber(d)o/IixNres Show Numbrr(H)ol!iz(ures <br /> A/C -air handling unds I Todel <br /> � Forced air systems � Bathtub <br /> � G.s p�pin9 I Lavalory(wash basin) <br /> Water healer � ShowM � <br /> Gas fireplace I Ki�chen sink&disposal <br /> � Gas ran9z Dishwasher <br /> I Clothes dryer � Clothes washer <br /> � Range hood Waler heater <br /> � Exhaust�an � Sink (service/badmopletc) <br /> � Heatpump � BackOoc+prevenler <br /> � Und healer � Unnal <br /> � Boiler Drmking Pountain <br /> � Refrigeralion � Floor dra�n <br /> i N�oodstove I Grease trap � <br /> Ducting � Roof drains <br /> � Other Medical Gas <br /> SPRINKIER / SUPPRESSION SYSTEM � other <br /> NumberolHeads � Other: <br /> I�ere�y cen�ly lnat I nave reatl antl e.aminetl Ihis apF�callen and kno::��e 5ame to 0e 1me ana cormU AlI provislens of Iaws and ordinances goveming I�i5lype o1 nork w�II Ee rompLetl <br /> wii�a heiner:pen11M�^rein er not i�e granting ol a permi Cees not presu ine m grve avinor.ty lo vio�ale or cancel�Ife orovision ol any c��cr stale or Icwl law regu�aling conslr��clion <br /> Thal I am autnorceC Cy i�e o�ener o�1�is pwpeny lo oerlen�Ine roih Icr v.nich appl�cs.ion Is matle and I comply�sun Ihe Slate CoNraciois Law 18 77 RCW antl 256 2COq WAL. <br /> / `fZ <br /> ��.,� 5/ �3 �� <br /> OwnEA�ihor4ed Ag�gnalure Dale (Revised 3/201J/ <br />