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� � <br />PERMIT APPLICATION <br />BUILDING/MECHANICALIPLUMBINGISIGN/SPRINKLER/DEMOLITION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 Cedar St., Everett, WA 98201 425-257-8810 FAX 425-257-8857 vrww everettwa.org <br />SITE ADDRESS�� 7 r r,/� <br />(iJ �fJ(/ I <br />LEGAL !or new consiroct�on. Sho�t �IaUsuL <br />, / PROPERTY TAX d <br />Yl r (.�/ <br />U� � Lot ho <br />� �ZZ--I� <br />�i�i��y-b(3 <br />(attach copy ol long legal tle;cripl;on) <br />LICANT:_Ocmer _Owne�'SAgen� �Canlretior � COniratl0Y5Agenl _Tfn3011�-�+��ro.-.ceom^erc!wro��.i•ronmao���r.ocowcnivinesc+:e� <br />TRACTOR �7�Z��ff%G �/S/Gfrl � JC.�C Stale Lic � ���� � ���� �ry Bus Lic. # <br />:55 �OJ��� 3�J'�J S{.U�/TX� �Q�� PncnelEm2il �!/�— �/ D._ � / Z" � _ <br />. �,...�.u� ,� �� �..� ,ff aH1� �U/1 N�s�i�u�< _.1 oS� /�! �rMl,v E �. �Q <br />�✓ y PhonaE�ma�l �i� — d'r�/ Z- / <br />BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK �•O�G <br />E.isting Use of Bwitlirg HEAT SOURCE <br />Proposed Use of Bwlding Gas_ Eieciric_ <br />B,�id�ng type. _ Singie FamJy _ Dupl?x _Townhouse _ tdulli-Family _ Commeraal <br />� <br />O�he: <br />f��pe ol pro�ecl. New Add�tion Remodel Repair _ T.I _ Sign _Sprinkler _Demolition_Change ol Use <br />JESCRIPTIONOFWORK(avdr,ionaispaceprovidedenlneback): C� �/���� %jiU� <br />�•�zs �� �i� �2 ,� <br />% a 1 hs7�4.1� G�- � , �� . ,,�/ / <br />-�v/� ''S ` � iL� 7,1�liC� G'��! a-��CDf�c/t.0 G{ J�"�'/Sj� !'Q G G�J.i(� <br />ro� s/ l> 47 .• O � <br />M CHANIC L PE MIT A LICATION PLUM NG PERMIT APPLICATION <br />'ype ol ProJed: _New _Addn _Alteration _Repair Typo ol Project: _Now _AtlOn _Altcratlon _Ropair <br />Show Number (HJ ol lixiures Show Numbcr (d) o/ /ixfures <br />� NC — a�r handling unils I Toilet <br />I Forced air svstems I �athtub <br />� Water heater <br />Gas 6replace <br />� Gasrange <br />I Clothes dryer <br />; Ranqe hootl <br />� Ezhaustfan <br />� Heatpump <br />Und hcater <br />� l3odcr <br />Refr�gcralion <br />Woodstove <br />Duc�ing <br />� Olher <br />SPRINKLER/SUPPRESS <br />Number ol Heads <br />SYSTENi <br />Si <br />Ftoor dram <br />Roof drains <br />Medical Gas <br />Other <br />Other. <br />I ncic�y cendy I�al 1 nove icad anC e.ammetl ihi, app5wtion an0 knov: I�e same lo he Ime and correct Ail provisions oi laws anG orCiwnces govemmg I�is IyFe ol wo�k �nil be compbea <br />v:Ah wne:her spcuGCO Pcicin or no1 Tne granting of a penni� Joes nal 0�esume 10 9ivo aWhorily lo violale or canccll�e provlsion of any clper :!ale or IOWI la.v te9ulnling conslruclron <br />ina� I am avlhw¢c0 Cy Inc c�mer ol inis proFeny la DeNorm Inc xoik lor xnicn appLwtim is ma0e antl I wmply wnh Ine Slalc Conlraclors La�.v 1017 RCW an0 296 200A W�C / <br />�� � <br />OwnerlAuthorized Agenl Signawre Oate (Re��setl3n.0f3) <br />/ <br />�5. <br />�� <br />