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,'ERMIT APPLICATICR <br />BUILDING/MECN •`•NICAL/PLUMBING/SIGN/SPRINKLER/DEMOLITION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 Cedar St., Everett, WA 98201 425-257-8810 FAX 425-257-8857 www everettwa ory <br />�.IIrj—IS <br />SITE ADDRESS: <br />epOPEATY TAX <br />PERMIT O :I <br />G <br />53 I5T 51-5'E <br />LEGAL for new construction. Short Plallsubdivislon __Lot No — (attach copy of long legal description) <br />Li �S' -2Si- QI <br />OWNER W MLLIC-K MMIE <br />PhonelEmall )f3 <br />Address t-t ( V I'(W <br />CAy1Slalo2'P Eli-af- t , r <br />APPLICANT: _—Owner _Owners Agent __Contractor _Contradofs Agent _Tenant(mm ver4rknedaonsentaom me o,wmno a9 won In eN atanl <br />CONTRACTOR ObkLd <br />State Lic. # City Bus. Lic. # <br />Address I Phone/Email <br />FOR PERMIT <br />iCOTACT <br />Ptione/E mad <br />BUILDING PERMIT APPLICATION <br />CONTRACT PRICE OF WORK OOt) <br />Exist,ng Use of Building -'e psi i4 HEAT SOURCE. <br />Proposed Use of Building t` _ Gas_ _ Flettric ✓ ? riot_ <br />Building type. ✓Single Family _ Duplex Townhouse _ Multi -Family __ Commeraal <br />Type of project* New Addition Remodel VRepalr T I Slgn Sprinkler Demoldion Change of Use _ <br />DESCRIPTION OF WORK laddbonalspacnwovmedonthe back) Upgf4�Q k �ckiu f�j�uk�dbOWs NeyE <br />'e ��d 2 EyLkcvs t- '• <br />V•fq�`�yOQYd T J��S�I4t IQn ) r 2 t .4at..S v p do <br />P t d "'M'a ) <br />l 1«1fIC41 Q<rta•T wT11 h¢ to rIe C�Yt lIgM . <br />MECHANICAL PERMIT APPLICATION <br />PLUMBING PERMIT APPLICATION <br />Typo of Project: _Now_Addn Altarallon_Ropa!r <br />Type of Project: _New_Addn _Alteration TRepair <br />Show Nur rbar (e) of fixfums <br />Show Number #) of fixtures <br />A/C -air handling 'inits <br />Todel <br />Forced ads stems <br />Bathtub <br />Gas piping <br />Lavatory (wash basin) <br />Water heater <br />Shower <br />Gas fireplace <br />Kitchen smk 8 disposal <br />Gas range <br />Dishwasher <br />Clothes dyer_ <br />Clothes washer <br />Range hoot <br />Water healer <br />�c, <br />Exhaust fa.l <br />Smk aerate/barlmo etc. <br />L <br />lieat PuraP <br />Beckpow reventer (inside b!d) <br />Unit heater <br />Urinal <br />-- - -__- <br />Boller <br />Drnkmg Fountain <br />Refrigeration <br />Floor drain _ <br />- <br />� <br />Wnslove <br />Grease Ira <br />u <br />Roof drams <br />- _ <br />Other <br />Medical Gas <br />SPRINKLER <br />I SUPPRESSION SYSTEM <br />Other __- <br />Number of Heads <br />Other. <br />I hereby candy that I have iced and esamned this application and know the same to be two and conacl AN plDMions of laws and ordmances governing this type of wok rv, I ee a coped <br />weirwhether specified hete'n or n0l The granting Of a Pang does her presume to give adhorny to vlulale or cancel The provisional any other slate or local law regulating construe bon <br />Thal I am authanteg by the owner of [his properly to perfarm the work for which app ceWn h See and I comply with the State Co lfaders Law to 27 NCW and 295 200A WAC. <br />fo 1S 2C/5 <br />wnorl ut oriza Agent signature tic (Howsed 4?0'bl <br />