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������ ����������� � <br /> ��I������������0������,��������I���������������������Q� <br /> � C1TY OF EVEREI'T PER�IIT SERVICES <br /> 3200 Cedar St., �verett, WA 982�1 425-257-8810 FAX 425-257-8857 www.everettwa.org <br /> �J_1 l <br /> SITE ADDRESS_:� PROPERTY TAX#! PERMIT# �,t'�� <br /> �z"-F��If N�e.CC C � � `i.�-'r�t' �.�-'/�� f£���0�> I'�� �l�l fG'D P�JL���CJG' �/ V�ll�-�� <br /> L�GAL for new construction, Short PlaUsubdivision Lot No. (attach copy of Ibng legal description) <br /> OWNER „!r ,,,, . Phone/E-mail y -- 3pl�- <br /> Addfess � City/State/Zip �, L,j�r <br /> y�3-s 'rti- f.v-� -•�G�- ' .,��i c{` <br /> APPLICANT: ✓Owner _Owner�s Ageflt _COfltfaCtof _Cofl1faCtof�S Age�t _Tefla�t�must proyida a letler of consent from the owner fo dp work In Ihe space) <br /> CONTRACTOR ,�, �,��� State Lic,# Clty Bus. Lic.# <br /> Address Phone/Email <br /> CONTAGT FqR PERMIT <br /> PhonelE-mail ,;'J}-3�f� —j J � <br /> BUILDING PERMIT APPLICATION coNTrzacT PRICE oF woR►c <br /> Existing Use of Building HEAT SOURCE: <br /> Proposed Use of Building �,i�IC.�L�s ��kMll:�-�-S�D�� Gas� Electric other <br /> Building type: ,�Single Family _Duplex_,Townhouse _Multi-Family _Commercial <br /> Type of project: ✓" New ,_Addition _Remodel _Repair_T.I._Sign_Sprinkier_Demolition_Change of Use <br /> DESCRIPTION OF WORK(additional space provided on the back): <br /> ,NC�-a/ Gw���i� ����lC�'t`c j � <br /> C'v�,�5TC1-v�-� N�w 3 S 5.►� 5 �►���� �k��+�� �5►�Enr�� <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type of Project: �New_Addn _Alteration_Repair Type of Project: �;..,New_Addn �,Alteration_Repair <br /> Show Number(#)of fixtures Show Number(#)of fixtures <br /> A/C—air handling units j l'oilet <br /> f Forced air systems Bathtub <br /> � Gas piping y Lavatory(wash basin). <br /> Water heater Shower <br /> v . Gas fireplace Kitchen sink&disposal <br /> Gas range / Dishwasher <br /> Clothes drye� Clothes washef <br /> Range hood eater <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 Flpor drain <br /> Woodstove Grease trap <br /> � Ducting � Roof drains <br /> I Other Medical Gas <br /> SPRIQd�LER / S�1PP�2ESSIOSd SV�STEM Other: <br /> Number of Heads Other: <br /> I hereby certify that I have read and examined ihis application and know the same io be irue and correct.All provisions of laws and ordinances governing this iype of work will be complied <br /> with whether spe�ed herein or not.The granting of a permit does noi presume to give authority to violate or cancel ihe provision of any other siate or local law regulating construclion <br /> That I am a or d by ihe owner of this property to perform ihe work forwhich application is made and I comply with the State Contractors Law 18.27 RCW and 296.2DOA WAC. <br /> - �L��� �� �� l 1 <br /> O n r horized Agent Signature Date (Revised 4/2015) <br /> i�z. <br />