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0 <br />PERMIT APPLICATION <br />BUILDING/MECHANICAL/PLUMBING/SIGN/SPRINKLER/DEMOLITION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 Cedar St., Everett, WA 98201 425 257 8810 FAX 425.257-8857 vNAv everethva.org <br />SITE ADDRESS: <br />D4,61 W4L,,i 5'R�T <br />PROPERTY TAX a <br />CC4&73a�� <br />P MIT <br />LEGAL for new consimclion Shen Plat✓subd S,cn LOI ho (attach Copy of long legal 005C1,01101 I <br />S�S <br />OWNER Z4e#1 5J0(/S�� <br />Phone/E-mad ,yap o�{"��'v <br />`7 �� <br />Address � �(/�. Wnlllti4-�fV�( <br />,r1 <br />Cdy/Stalet2ip „r—P pl*) TD V <br />APPLICANT:_Owner _Owners Agent _Contractor _Conlractor's Agent Tenanl;mni ae+eea 4na o'rnnsem horn me o.,rcrbaa.00 m.ne snace <br />CONTRACTOR (FC'D kC • <br />State Lic of OBI 104 k• City Bus Lic a <br />Address �33a fol� 4�1 �idwam lelr'. 9 Phor•e Ema lc4H28N-3333 <br />TENANT BUSINESS NAME <br />—IWQ)5 'ro%7 • Zae- of �y <br />CONTACT FOR PERMIT <br />Phone/E-mail <br />BUILDING PERMIT APPLICATION <br />CONTRACT PRICE OF WORK 4. <br />Existing Use of Building At7 I_ _ NEAT SOURCE <br />Proposed Use of Building ___ Gas �Electr c_ Other__ <br />Building type _ Single rantlly _ Duplex _Townhouse _ Multi -Family _ Commercial <br />Type of project _ New _ Addition Remodel Repair _ T 1 _ Sin Spnnkler _Demothon_Change of Use <br />DESCRIPTIO OF WORKraddmonat space provided 00 the back)l. <br />MECHANICAL PERMIT APPLICATION <br />PLUMBING PERMIT APPLICATION <br />Type of Protect: New _Addn _Alteration _Repair <br />Show Number (a) or fixtures <br />Type Of Project. _New _Addn Alteration _Repair <br />Show Number (a) or fixtures <br />L <br />A/C —au handling units <br />Toilet <br />_ <br />Forced au systems <br />Bathlub <br />j Gas piping <br />Lavatory (washbasin) <br />Water heater <br />Shower <br />Gas fireplace <br />Kitchen sink & disposal <br />Gas range <br />Dishwasher <br />Clothes dryer <br />Clothes washer <br />Range hood <br />Water heater <br />Exhaust fan <br />Sink (service/battmoplelc ) <br />Neat pump <br />Backflow preventer <br />Unit heat- <br />Urinal <br />Boiler <br />Drinking Fountain <br />Refrigeration <br />Floor drain <br />Wootlslove <br />Grease trap <br />_ <br />Duchng <br />Roof drains <br />Other _ <br />Medical Gas <br />SPRINKLER / SUPPRESSION SYSTEM <br />Other <br />Number of Heads <br />I <br />Other. <br />1 hereby cendy that I h e read and e.ammed Inap lca'mn and knowthe same to be true and coned All provisions of laws and ordinances governing this lype of work will be compiled <br />.in whether spent' d h '..ad <br />or net The ant, <br />g a ermd m does not presume to gwe authority to vielale or Cancel the provision of any other slate or local law regulating wudion nstr <br />That I am a' 0 2 d by a own r f IhI prope y OP dorm the work for wtitn appl canon is made and I comply with the State Contractors Law 19.27 RCW and 296 200A WAC, / <br />y 2. <br />ay <br />Owner: y IynahrtC =1a1�� (Revised 32073) <br />