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/ <br /> i�ERIVIIT APPLI�ATIC;�a <br /> BUILDING/MECH/�I�ICAL/PLUMBING/SIGN/SPRIIVKLER/DEMOL,ITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 Cedar St., Everett, WA 98201 425-257-8810 FAX 425-257-8857 www.everettwa.org <br /> SI A ,RE „ L " r, PROPERTY TAX# �7 PERMIT# <br /> - � �r i.> � (` ti, �d Z. �/�{'� �JG�C� � ��� � � ' ..'C. <br /> LEGAL for new construction: Short PlaUsubdivision Lot No. (attach copy of Ibng legal description) <br /> OWNER � �— %VY�Lf� VG Phone/E-ma' �S� � ) �Z�,� _ ' �' <br /> � �{� 1 � L <br /> Address I��_� I �' C ,� City/State/Zip C� , C `��� �" � ) C' �Jr�'� � <br /> APPLICANT:�Owner _Owner's Agent _Contractor _Contractor'S Ageflt _TeflBflt(must provide a letter of consent irom the owner lo dp work in the space) <br /> ,i r <br /> CONTRACTOR , �, � State Lic.# ` � �-{� 3'�� City Bus, Lia # <br /> Addres �� �J ` � r L7�, � L, L��� Phone/Emai �� `'� � ��" <br /> Gt"�`� T,,�OR PERMIT , - <br /> L���I r1�5 C'lC✓vte��%�Y tC.ui <br /> Phone/E-mail '�+C'"7�. ��l'Z,�"� ��l.l' � C 'i � <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK <br /> Existing Use of Building "�' H AT SOURCE: <br /> Proposed Use of Building � � $` Gas Electric_ Other <br /> Building type: ��ingle Family Duplex_Townhouse _Multi-Family �Commercial <br /> Type of project: � New Addition _Remodel _Repair_T.I._Sign_Sprinkler_Demolition_Change of Use <br /> D SCRIPTION OF WORK(additional space provided on the back): , <br /> ���Y15�tiU.C�,1� 1�1`���'d�.�jjE�( U�,�1�� L;�I� 1'1..�l�e:>�:���t��,c/ Vk.._�KG' , U�i�� �S, Id��C��(°le p�=. <br /> � f�b u�.�c� � <br /> �I�I,Cv'�.1��L�t.�'lC�� <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 Toilet <br /> Forced air systems Bathtub <br /> Gas piping Lavatory (wash basin) <br /> Water heater 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 /> — I Refrigeration — Floor drain <br /> --- � Woodstove .�! Grease trap <br /> ' I Ducting _ � Roof drains � <br /> ! Other _ Medical Gas <br /> SPRINKLER / SUPPRESSION SYSTEM Other: <br /> Number of Heads Other: <br /> I hereby certify that I have read and examined lhis application and know lhe same to be true and correct.All provisions of laws and ordinances governing lhis type of work will be complied <br /> with whether specified herein or not.The granting of a permit does not presume to give authority to violate or cancel the provision of any oiher state or local law regulating construction <br /> T at I am authorized by the owner of this property to perform the work for which application is made and I comply with the State Contractors Law 1827 RCW and 296.200A WAC. <br /> ' ` �;°� 11 <br /> , <br /> OwnerlAuthorized A nt Sig a D te (Revised 4/2015) <br /> ��,(���.. }������ 'j(� <br /> � I Z <br />