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��Rf1�9� A�w�,����B�u� <br /> ��IL.pINGIMF�G�1AMiCAI�/P�_UMBIRIC/SIGN/SE�RINFC�,�R/A�9VIq�ITIOh� <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 Cedar St., EvereU, WA 96201 425-257-8810 FAX 425-257-8857 wnvw.everettwa.org <br /> SITE AODRESS: ��,-- — PROPENiV TAX p _�'—� P�MIT `1� <br /> �,zo ae,.��tf�,� _ �____�� �� '��!- <br /> LEGAL for new conslruclion: Short PlaVsubtlivislon_ Lot No._ (attach mpy of long Ie9al de,cription) <br /> OWNER t�e�(!.�'[' �D�.U�`tDi,U� �7T�[!11[+L PhonelE-mail �'LS ' z�',S(JD <br /> n�a«55 23� NV1.�J�-I'F _�._._!_. City/Slate2p �,UCYvrR,_u/a_—�201 _ ��..__ <br /> APPLICANT:_Owncr _OwneYsA9en1 LCGnlracror _CanlracloisAgenl _TenanifR�+�v��+�va:citrr�i«r.s�mimmm�o.,n�i�oo��.c�winmcsv�=�1 <br /> CONTRACTOR �J� ��k� �P[1"G `� ���uE(R�- Slate Lic.# E.V�Qr�OL2(JT City Bus. Lia � pp'7yS�j <br /> Address 2�� �G�YI� �C. K�tv� �,Uq �D2U� PhonMEmail 4L�^ ZSZ'�llu <br /> CONTACT FOR PERMIT <br /> kJt/�Tt' �Q.�1 u�/� �i7D�°tl Y�AiC1L @ �55M�A• �wti <br /> PhonelE-mail 2�s-Zy�-��.V�U � <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK � <br /> Existing Use of Building '�TO1(1'�(aF - �NC eaA'A)(�� _ HFJ1T SOUHCE: <br /> Proposed Use of�uilding �`L�Z � �O �uf�l�GT Gas K Electnc_ other_ <br /> Building type: _Single Family _Duplex_Townhouse _hlulti-Family K Commercial <br /> Type of projeaC _New _Addition _Remodel Repair__T.I.__Sign_Sprinkler__Demolition_Change of Use <br /> DESCRIPTION OF WORK�addlrional space pm�•medon fhe back): <br /> FZ .�� �-l� � (�'�(a - SAwws �J�k11r 6fts �..�ncd - RL- �5.� �y�qT�Mb E�S EN�M�i.T <br /> U��'Ciw, All c$v�..�T tNs�pe e��- <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type ol Project: _New_Addn _Alleralion�Repair Type ut Project: _New_Add�: _Alteration_Repair <br /> Show Num6er(p)ollixturcs Show Number(p)oI�xfuns <br /> A/C-air handling units Toilet <br /> Forced air systems � �3thtub <br /> Gas pipipg L�vatory(wash basiN _ <br /> Waten c�ater Shuwcr <br /> Gas fmplace Hitchen sink 8 disposal <br /> Gas ianyc Di,htivasher <br /> Clothes dryer Golhes vr.isher <br /> Ran9c hood 4Vatcr heatcr <br /> Ezhaust fan ---I Snk(seNice/badmople;c.) <br /> -- Heal pump [3ackflo�v preventer(inside bldg) <br /> Unit hcate� Unnal <br /> � �oiler [7r.nkin9 Fountain <br /> Refri�eralion Floor drain <br /> Woodstove � Grease Irap <br /> � Ducting I Roof drains <br /> � Olher i:edic.l Gas <br /> SPRINKLER / SUPPRESSIOId SYSTEM o�her: <br /> Number of Heads O�her. <br /> I he�eby cetlity Ih�i I have ttad anJ e�amined IMs nppllealion and f.now Ih�samu'o be Iruu anJ cm�ecl.All piovisian,ol laws arA otdinanee,governinq IAi,Iype oMnB w.11 Du cump:'',eA <br /> N+N��I�elher�pedf,ed herei�or noL Tho 9mnlin9 0l o pe�m'�1�oea nal P�r;urne l0 9rvn aWhonry to violate cr nncel t�a Fmvi,ion ol any alhw;la�e or�oc�l law re9ulatin9 ecnslmclion <br /> Th:J I am aWhonxed hy Ihe mtnerol��is piopeity lo pedenn I�e wmk lor�v�:c�appllwtion Is m�de and I�omp:y��i�h i�e 5!ate C.aVaclms Law 10.:7 FCl7and 7.9G.70DA IVAC. <br /> ��`�-- �(�28- 1S <br /> OwnedAu�lmri•.d entSi9natwc Dote (ReVlsed4/20I5J <br />