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• <br /> � � - �`� QC�pLaG °;`�QoC�� <br /> I���.�ii <br /> C��DI��I���/�L��C���9����/�����l�9�/�Sc��/�PG�a�IG��,��/����L�Q`���� <br /> � c��v o� �v����r ����i� s��v���s <br /> 3200 Cedar St., �verett, WA 98201 425-257-8810 FAX 425-257-8857 www.everettwa.org <br /> SITEADDRESS: PROPERTYTAX# PE MIT#� _�� <br /> 1� ��: -�cL„"�`f� ��t,t • <br /> L�GAL for new construction: Short PlaUsubdivision Lot No. (attach copy of long legal description) ' <br /> OWNER ,�1-1rL1a��(y` l �i1 Phone/E-mail '�{ Z��3���- �:'�• � . <br /> Address j f?�� City/State/Zip ." �- ��, � /� �(,�7�l <br /> AFPLICANT: Owner _Owner's Agent �.. Contfactof _Contfactor's Age�t _Tenant(must provido a le4er ofconsoNfrom the owner to dp work in ihe space) <br /> CONTRACTOR ����.����=-�( �.�7-Lti.i� -�-,��'��E'[)�.— State Lic,# �,����C?L��l City Sus. L.ic.# L'ic.��?`���j • <br /> Address ��Zv ��`'��. {��,1 V� ��1;=���. I.�,t'� ��(��( PhonelEmail �-�'9•- 'Z�2 �"�I��-/ <br /> CONTACT FQR PERMIT <br /> ��1r�V�41r��( �`��%�vi 1'�'''� ,C�'%..�� <br /> `����.�\t 0 Phone/E-mail �-1 �9 7 l.� Z ����L� <br /> BUI�.DING PERMITAPPLICATION coNTRa.cTPRIceoFwoRrc �'�,<<'�' <br /> F cisting Use of Bullding � �-��1�`�� HEA�T'SOURCE: � <br /> Rroposed Use of Buildin� �"��- �--��'�'�`°' Gas � Electric other <br /> Building type: ,_Single Family ____Duplex_Townhouse _Multi-Family y_Commercial <br /> Type of project: New Addition _Remodel ,�Repair_T.I._Sign_5prinkfer_Demolition_Change of Use <br /> DESCRIPTION OF WORK(additional space provided on fhe back): � <br /> .� / / / ( <br /> �c � '. �,t�-;_ \t�,15 ��311\ �{Ct� ��1��&�g��.� �✓. � �',i�t4v 7f4�''(\ ���i�!!(iE`9 � � ;��'�'4.0 t r''�G�.� r���'1'• �; t�: %(�C_ <br /> J r � <br /> MECHANICAL PERMIT APPLICATIOId PLUMBING PERMIT APPLICATION <br /> TypeofProjecf: _New_Addn _Alteration,_[_Repair TypeofProject: _,New_Addn ,_,Alteration_Repair <br /> Show Number(#)of fixfures Sho�v Number(#)of fixfures <br /> A/C—air handling units � Toilet <br /> Forced air systems Bathtub <br /> Gas piping �avafory(vrash 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 Backflov✓preventef(inside bldg) <br /> Unit heater llrinal - <br /> � Boiler I Drinking Fountain � <br /> Refrigeration Floor drain <br /> Woodstove Grease frap <br /> � Ducting � RoQf drains � � <br /> � Other Medical Gas <br /> �f'I�IIt�'�SL�.�R / ��1P6�r�I���ll�FC9 ��(����fi Other. <br /> Number of Heads Other: <br /> I hereby certify that I have read and examined ihis appllcaiion and know ihe same io 6e lrue and correct.All provisions of laws and ordinances governing ihis type of work will be complied <br /> wilh whe(hef specified herein of not,The granting of a permit does not presume to give aufhority io violate or cance�ihe provlsion of any othef staie of local laW regulating constructlon <br /> That I am auihorized by ihe owner of this property io perform the tvork for which application is made and I comply with ihe Siate Contractors LaW 1 a.27 RCW and 2sG20oA WAC. <br /> "�,,\ l j/'�a— ,'S_ )_.i L;. <br /> �3C l�_r <br /> Owner/Authorize entSignature Date (Revised4/2015)-- <br /> ,��/ <br />