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��lft��� ��������1 <br /> �llIl��IfV�/�E�H��fC�►�./PLI�M�IiVG/�IG�I/SPRIIVKLER/DE�IiOL,IT'lOIV <br /> CITY OF EVERETT PERIViIT SE�4VICE5 <br /> 3200 Cedar St., Everett, WA 98201 425-257-8810 FAX 425-257-8857 www.everettwa.org <br /> SIT 4AR�SS: ,, � PROPERNTAX�� PERMIT# <br /> I � � � C'%�, C��C', D%� . E'�O%��' ���j'c���s U�%��;C%t=' �' f�0� ,� �� <br /> LEGAL for new construction: Short PlaUsubdivision � � � �'��'� �� � Lot Na�✓' (attach copy of long legal description) <br /> OWNER;°`� ��- ��(���������, Phone/E-mail ��/�UL (�,'�-��/ f�C ������7_.C�;� �ZOP��: � � <br /> Address Z � � �-� —1/��� L�LL�L.. City/State/ZiP -��--E��v� '� � L ��j� Z�C� 7 <br /> APPLICANT: �Owne _Owner's Agent _Contractor _Contractor's Agent _Tenant�must provida a ieuer of consem from ihe owner io ap work in me spa�e� <br /> CONTRACTOR �— �-'�L / �,� State Lic,# City Bus. Lic.# <br /> Address Phone/Email <br /> CONTACT FOR PERMIT <br /> Phone/E-mail � <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK ���'� f C�(� <br /> Existing Use of Building , � HEAT SOURCE: <br /> /+ � <br /> Proposed Use of Building �"�6�,� Jt �t: J�'r � FGas L� Electric_ Other <br /> Building type: Si �Fam'ily �Duplex_Townhouse _Muiti-Family ^Commercial T <br /> Type of project: � N� Addition _Remodel _Repair_T.I._Sign_Sprinkler_Demolition_Change of Use <br /> DESCRIPTIO �F WORK(additional space providefi on the back)� <br /> ,:���,. �. `` (, --r ��/��i r . i � <br /> c t.�� � �.. ' i ;' � � �� ��% �.-�'�,''1 � <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type of Project: New TAddn _Alteration_Repair Type of Project: �New�TAddn ,_,Alteration_Repair <br /> Sh -Nulnber(#)of fixtures Sho�w-Nfimber(#)of fixtures <br /> A/C—air handling units Toilet <br /> I Forced air systems L= Bathtub <br /> � Gas piping i.� Lavatory(wash basin) <br /> Water heater Z L/" Shower <br /> Gas fireplace % ✓' Kitchen sink&disposal <br /> Gas range �/ Dishwasher <br /> Clothes dryer / Clothes washer <br /> Range hood / Water heater <br /> Exhaust fan Sink (service/bar/mop/etc.) <br /> Heat pump Backflow preventer(inside bldg) <br /> Unit heater Urinal <br /> � Boiler Drinking Fountain <br /> Refrigeration Floor drain <br /> Woodstove Grease trap <br /> 1 Ducting � Roof drains � <br /> � Other Medical Gas <br /> SPRIRVIaCLER / SUPPI2ESSIOId SYSTEM Other: <br /> Number of Heads Other: <br /> /� <br /> I hereby certify that I have read and exammed ihis application and know ihe same to be true and correct.All provisions of laws and ordinances governing this�ype of work will be complied <br /> with whether specife�d•b�ei0.o_r not.T.kie grant�of a permit does not presume to give authority to violate or cancel the provision of any other siate or local law regulaiing consiruclion <br /> That I am authorized by the ow---ne 4f'this operty�perform the work for which application is made and I comply with ihe State Contractors Law 1827 RCW and 296.20oA WAC. <br /> �;.� % '7� c� � /5 <br /> , ; .. <br /> Owner/Authorized Agent Signature Date (Revised 4/2015) <br /> � � � ��;� <br />