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� <br />�ERMIT APPLICATION <br />BUILDINGIMECHANICALIPLUMBING/SIGN/SPRIfVKLERIDEMOLiTION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 Cedar St., Everett, WA 98201 425-257-9810 FAX 425-257-8857 www.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />AODRESS: _ �:✓;.'itFTo��19Yto-�PROPERTYTARN PERMITr#Gf� <br />.. �,�, '�/� .t , , r- i ,.- c r - — o� � - O <br />for new :onsUuction: Short PlaVsubdivision Lot No.,_ (altach copy of long lagal descriplion) <br />2 l / ����1 i � //� k /( ��X � PhonelE-mail �/�✓ � � /1 UY O _ <br />. . . -T /:_ . . _ �... C�dviState/zio / �- , .: �- ,. , - ,— �I'- i_il3- �i,YJ . �i <br />i <br />_Owner _OwnersAgent�ontractor _Conlraclor'sAgent _7enanllm�sinro�a���enoroico�:��,�o-�mmo�«���rme,��rx�-,rt,e�p�=�1 <br />L567�1 <br />��, <br />&ILic.# �;� <br />Phone/6mail •,��z% — .� <br />BUILDING PERMIT APPLICATiON CONTRa,CT PRICE oF woRK <br />Existing Use of Building <br />Proposed Use of Building �` <br />Building t��pe: _ Single family _ Duplex _Townhouse _ Mul�i-Family _ Commercial <br />Type of project: _ New _ Addition ,_ Remodel _ Repair _ T.I. _ Sign _Sprinkler _[ <br />DESCRIPTION OF WORK (addifional space pmvided on fhe back) : <br />s�� r COE 6us. Lic. # <br />o .3J3 .�`ioc/ <br />HEAT <br />v�iJCi _/_�:�5 /-// ,�i �'��/���"� L tVSTN�� - �?�l,'G,CL� (li'An /Z�oc�o (Si V .. <br />/ <br />MECHANICAL PERMIT APPLICATfON <br />ofProject: _Now_Addn _Alteration_Repalr <br />Show Num6er (N) oI lixmres <br />- � NC — air handling units <br />Forced air systems <br />Gas piping <br />'� Water healer <br />�� Gas 5repiace <br />� Gas range <br />' � Clothes dryer <br />� Range hood <br />Exhausttan <br />� Heat pump <br />� Unit heater <br />� Boiler <br />i Refrigeration <br />; Woodslove <br />Ducling <br />� � Other ; �.,- r _<_i-, , �,,-�1� i � � <br />SPRINKLER I SUPPRESSION SYSTEM <br />� Number of Heads _ <br />PLUMBING PERNYIT APPLICATION <br />TypoofProJect: _New_Addn _Alloratlon_Ropair <br />Medlcal Gas <br />Olher <br />I hercoy certdy thal I have read antl examined Ihis appiication antl know the same �o be Irue and cortect. Ail pmvisions el laws and orC�nances 9aveinin9 tNs type ol xork wtll be comp'�ed <br />�t-,th v:hetnet specdica herein or not. The 9rantin9 ol a pertnM1 does nol presume to give authority to violate or cancel Ue p:ovision of any m�er slate er local law regulating ronslmcbon <br />ihot I am aut�orize7 6y the owner o/ l�is property to perlortn the eork for �+hic� applicotion is mado and I tompty wtb tho SWte Con:ractors La'x 1827 RCW antl 296 200A N'AC <br />7 <br />� ��i 1 �L �J L�_ �'"-��i'_LU/1 <br />OwnerlA lhorizedAgentSi�naWre Date <br />;Revisetl62072) II ? <br />