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PERMIT APPLICATION <br /> BUILDING/MECHANICALIPLUMBING/SiGN/SPRINKLER/DEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 Cedar St., Everett, WA 98201 -425-757-8810— FAX 425-257-8857—�.vww.evereltwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM � �aq �'I Z <br /> SITEADDRESS: � . - PROPEI�NTAXfl_ P MI # <br /> I���I S 12N` Q.ti���C '��. ?�,���� c� Wto.� �t,ct.� � - Uo3 <br /> LEGAL for new constmction: Short PlaVsubdivision� � �' � � ����. �' Lot No.� (allach copy ol long legal descriplion) <br /> /,' Phone/E-mall �l�le..UKE y"-', ��?U�l�ir`� ��.7�LCi1.%i.7.4k. (U' � <br /> OWNER (�./1/1(.Z� N �.�L�I�.(�.%Noi- � S <br /> [� 1_rl £, S+ F Ci�y/SIa1c/ZiP i�� CL�.I.'J Cl.1/�1 ��6'�73 <br /> Addmss ��(:�� C�� �`� _, r-, l <br /> CONTRACTOR ' /1/�CC�2 tii'•�Xh- (l.�'c"'{- L 8 I Lic. # L�N��,� �'�- r7ry J � L= <br /> � �11 mc , . :�✓isn� ���,g nna�. �: �, <br /> ��: ��C�7J Phane/f_mail �K <br /> ndd�ess I?�iiS l���y=:� �;l�� 5T� �cV ul��_: , �: ;Z , St7o.22�>•- <br /> TENANT BUSINESS NAME � CONTACT FOR PERMIT m�tLy/(�.. Vi�l� S h(_It:.l <br /> II �I / . Al•tr2: �r;[ V:�-lU �%7C�HtL inLL/yG:A�Z� LUr/7 <br /> �'� Phonel6mnll jj�j j���> .i?U`j <br /> BUILDIMG PERMIT APPLICATION coNTRac7 PRlce oF WORK <br /> Existing Use of 6uilding �_`�..��'�� / HEAT SOURCE <br /> Proposed Use of Building �i � 1 ��L7 n�Ll� �IJ��� (l��<<' Gas�. Eleclric_ Other_ <br /> Building type�. �Single Family _Duplex_Townhouse _Multi-Family _Commercial <br /> Type of projecC �New _Addition _Remodel _Repair_T.L_Sign_Sprinkler_Demolition_Change of Use <br /> Description o(Work(adddional space provided on fhe back): I1 .__j_j� c�I L� <br /> � �,1>�S 1 L �� �� <br /> , � i /L��� `-'-r i�,-�, �;�n4. c <br /> �C.��`�t��l�< �lv� �;� � <br /> Have you started working wilhout a permit? _YES XNO L-�'��{-����-��V�� j <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type ol Project: jNew_Addn _Alteralion_Repair Type ol Project: �,New_Addn _Alteration_Repair <br /> Show Nuntbcr(N)ol/ixfures Show Number(#)o/lixfures <br /> ( , AIC—aIr handlln9 units I Tollet <br /> I I Forced air systems ', Balhlub <br /> L � Gas piping _ � Lavatory(wal:�basin) <br /> i Water heater ,I Shovmr <br /> � � Gas fireplace Kitchen sink&disposal <br /> � Gas range I Dishwasher <br /> f;�� I Clothes dryer Clothes washer <br /> � Range hood - <br /> � Exhaust(an ; ( Sink jservicelbadmopletc.) <br /> Heat pump .� � Ba�kflow prevenler <br /> Unil heater �' � Urin:.� <br /> Boiier - � Drinrting Fnuntain <br /> � � Refrigeralion �� � Floor drain <br /> Woodstove � . Grease lrap <br /> � Duclin9 IS I Rwfdrains <br /> I Other j' I Medical Gas <br /> SPRINKLER I SUPP'RESSION SYSTEM , O�her <br /> �� � Olher. <br /> (;� �' Num6er �f f leads _ - � <br /> I hemby cerlily Ihal I have rend and ea�imined this apPlicalion anA know Ihe saine to be true and correct.All provisioas of laws and ordinances governing <br /> tlus type of woik will be complied wdh whelher specilied herein ar not.The gran�ing af a petmi�does nal presume�o give au�horily�a viola�e or cancel <br /> tt�,e pravision of any other stale ar local law re ulaling conslruction or�he pertonnance ol conslruclion. That I am aulhorized by ihe o�vner of this property <br /> Io peifoim the wo�k lor G��p{ � '���on is nt de and I comply wilh Ihe Slate Conlraclors Law 1827 RCW and 2'J6200 WAC <br /> '��� <br /> �� �,26��L <br /> �i�� (Rewsed 2207 U <br /> OvmedAulh r\ed Ac7GtYSignaWre _ � � <br /> �� � y <br />