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� � . <br /> . ������ �������A�IY�� <br /> ��l�I��QG��/���f����99��1�/1���f��9�9G/�9��/�G°�G��h��LCG�3l����Q�`���� <br /> � ���°v �� �v�����° ����t� ����►��� <br /> 3200 Cedar St., Everetf, WA�82Q1 425-257-8810 FAX�25-257-8857 www.everetiwa.org <br /> SITEADDRESS: PROP�RT`1TAX# P ;i <br /> � I-1 c� Y l.�r�iu�' � � ". <br /> L�GA�for nevd construction: Short PlaUsubdivision Lot No, (attach copy of long legal description) ' <br /> OWNER (Jt v�Cr ��U[ G� Phone/E-mail �Z� —��/—�U/b' <br /> Address f L�(��, � ����GE �'>`%/,(; � CitylSfate/Zip L�..V�L� . VL%,A �� ��'(�' <br /> APPLIG!-1NT:_Owner _Own r's Agent �,Coniractor _Confractor's Age�f _,Tenant�mu5t providp a Ien�r ot�onsanitrom me owner�o aP wor�c in�he Spa��) <br /> CONT�AG1 O-P. �W@d��.�����-�( �i'�Pc� ��F"���16`7�:., Sfafe Lic.�# ���d�.-��`��'����� � City 13us. Lic.# �G`��G�`7 . <br /> Address ���i.> i f�C-l�f,�. ��.: �����_ U..l�� ���1 PhonelEmail �C��r' "�`�`2.j��� <br /> � ,, (;�iVT/�CT FQR PERMIT � <br /> r � �-1.�dv�� <br /> (�-L��CI �V,--�� ������-I���� ���:'. <br /> Phone/E-mail `tZj -2 �2 -�j//�l <br /> RUI�DING �ERMIT.I��P�.I�ATIOI�1 COfdTRAC�'PRICE OF WOR4t � GC%� <br /> Existing Use of Building � �� C����'t HEAT SOURC�; � � <br /> Proposed Use of Building �� �� ���'�t Gas � Electric �ther <br /> Building type; �Single Family _Duplex_,Townhouse _Multi-Family �C Commercial <br /> Type of projecf: _New Addition _Remodel �Repair_T.I._Sign_5prinkler�Demolition_.Change of Use <br /> DESCRIPTION OF WORFC(additional space.provided on the back): ' <br /> � k,YV\C f,-c' �, ���l.�G i' `� `)c(�i l��t'� � �/�.'�`f ��i�4'Z'� <br /> �;,U��}"�Q��Iv �>�! i�c,"�.�e c�� �i�,..d.� . <br /> MECH�INIG�IL PER11l11'�'�1PPLICA�'1�� �LLIMBIIdC FEi�M17'AI�E�LI��TIGlIW <br /> Type of Projecfi _New_Addn _Alferafion�Repair Type of Project: _,Nevr_Addn ,_,Alferation_Repair <br /> Sho��Number(�)offixtures ShowNumber(#)offixfures <br /> A/C—air handling units l"oilet <br /> Forced air systems Bathtub <br /> Gas piping LaVafory(�vash basin). <br /> Wafer heaier � Sliower � <br /> Gas fireplace Kitchen sink&disposal � <br /> Gas range Dish�vasher ' � <br /> Clothes dryer Clothes washer � <br /> � Range hood Wafer heater <br /> � � Exhaust fan ' Sink(servi�e/bar/mop/etc,) � <br /> Heat pump Backflov✓prevenfe�(inside bldg) � <br /> llnit i�eafer �- Y1� j ' Urinal • <br /> � Boiler Drinking Fountain <br /> Refrigerafion Floor drain � <br /> � Woodstove Grease frap <br /> I Ducting J Roof drains <br /> � Other Medical Gas <br /> �P�lI�'�L�L� /��9�G�Ir����➢�F�1 ���1���if� Ot(�er: <br /> Number of Heads Other: • <br /> � ��te�eby cerfiFy that I have�ead and examined ihis applfcation and know ihe same io be true and cor�ect.All provisions of laws and ordinances governing ihis iype of wotk will be complied <br /> tvitll wh�'�itef specified herein o�not,The granting of a pe��nit does nof presume io give aufhorify io violate or cancel tlte proVision of any othef s{ate or local law regu)ating wnsiruciion <br /> That I arn aulho�ized by ihe ovmef of this prope�ty to perform the tNo�k forwhich application is made and I compiy with ihe Siate Contracio�s Lav✓1 s.27 RCW and 29s,2ooA VyAC. <br /> '�� C�,`� �0 /U / <br /> p�et3Auff�oriz enf Signature Date (FZevjsed 4/2015) <br />