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�'�'�'c. c,� �;►-t,�' �,�;�,C- � l��t�n�.�.� �.o� � 2�7 - C� G� � � <br /> PERMIT APPLI�AT�IC?t� <br /> BU ILDINGIMECHA�JIGAL/PLUMBING/SIC,NISPRINKLERiDEMOLITitJN <br /> CtTY OF EVERETT PERMIT SERVICES <br /> 3200 Cedar St., Everett,lNA 98201 425-257-$810 FAX 42�-257-8857 wvvw.everettwa.arg <br /> 51TE ADpRESS: PROPERTY TAX# I #( �� r � �� <br /> _ �'+C� "� �r C?f�5 oC)1�Cl � � <br /> LEGAt for new cronstruction: Short PlaUsubdivision Lot No. (attach copy of long legal descnption} <br /> OWNER y►t � PhonelE-maii 2 C��,p • z,��^{y �p�(�, <br /> Address ��� , �r^. City/StateiZip (��� <br /> APPUCANT:�Owner �Owner's Agent ont�aCtO� `COttYtgCtor'S AgE11t �T@tiaFl�(must providu a letter of cOnsent from the owner ta do work in�he spaca} <br /> CONTRACTOR �� �,g State Lic.#����� �2,City Bus. Lic.#(�,�$Sy„5 <br /> Address �y� `('�(�� �t �g)$� PhonetEmail z()�p• �',,�, - (�,(�}� <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT <br /> `�A-'`�tirtt7�,, - �,t�,'t�r t r�r �'�,+"�'tG+ccS�-.•t'��"'� <br /> Phone/E-m�il <br /> BUiLDiNG PERMIT APPLtCATION eO����-P�i��p�WOR U� <br /> Existing Use of Building HEftT SdURCE: <br /> Proposed Use of Building Gas €iectrie other <br /> 8uifding type: _Single Family _puptex,_7ow�house _Multi-Family _Commercial <br /> 7 of ro'ect: New Addition Remadel Fte ir T.L Si n S'�in�kVer L?emolifion Chan e of Use <br /> DESCRIPTION pF WORK(addrtionat space provided on fhe backj: <br /> �x4-cnd �;�S 1 i ne i g a- rc..r�G, <br /> MECHANICAL PERMIT APPLiCAT10N PLUMBING PERMIT APPLICATION <br /> Type of Projecl: New Addn _Afteration_Repair Type oP Projeat: _New_Addn Aiteration Repair <br /> Show Number(#)of frxtures Show/Jumber #J of frxtures � <br /> J AIC—air handlin units ! Toilet <br /> Forced air s stems Bathtub <br /> i Gas i in Lavato wash basin <br /> Water heater Shower <br /> , Gas fire lace Kitchen sink&dis osai <br /> � Gas ran e Dishwasher <br /> ' Ciathes d er Ciothes washer <br /> Ran e hoad Water heater <br /> i Eachaust fian Sink servicelbar/mo /etc. <br /> Heat pum Backflow reventer <br /> Unit heater � Urinal <br /> Boiler Drinkin Fountain <br /> } Refri eration Floor drain <br /> Woodstove Grease tra <br /> Ductin RooF drains <br /> Other Medica�Gas <br /> SPRINKlER/ SUPPRESSION SYSTEM other: <br /> � Number of Heads Other: <br /> I hareby ce rFy that I have read and exami�ed ihis appiication and know the same to be Frua and correct.Aii provisions of laws and ordinances gaveming tnis type of work wiil ba comp <br /> with whethe p d atein or not The granting of a permit does not pfesuma to grve authority to violate or caocei the provision of any other state or locai iaw reguiaGr,g constnaciion <br /> That V am au nzod the ovm r oF this property to erForm ihe woric for which appiication is made and I comply with the State Cootraciors Law 1827 RCW and 296.200A WAC. <br /> L'�-�`"" _-"' / ! -1lv-Il� <br /> Owne uth ized Agent Signature Date {Revised 9/201 A) <br />