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yvtitjw,A <br />Y <br />L• <br />PERMIT APPLICATION <br />BUILDING/MECHANICAL/PLUMBING/SIGN/SPRINKLER/DEMOI.ITION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 Cedar St., Everett, WA 98201 - 425-257-8810 - FAX 425-257-8857 - www.everettwa.org <br />ARE ACCEPTED FROM 8 AM TO 4 FM " 7 1 l ` // <br />PROPERTY TA% # <br />aERM1T # <br />SITE ADDRESS: <br />9so6 l9Yat v�trve S� <br />zSosr8��90(100 <br />LEGAL for new construction Short Plat/subdivision Lot No._ (attach copy of long legal description) <br />OWNER W(C14ALZ,2 C+lrti(b JL4'4IF�2 N�aL/ <br />Phone/E-mail O4,-7Z(o- �2'55 <br />Address Q �Q 895 84 <br />// <br />City/StatefLip %Eg7-r49 WA 98/24 <br />%IQ(D2wj �� <br />TRIDECCoB�DZ Z�rZ Zola <br />CONTRACTOR ,QULTTOI-1Co•�l-/LL&ILic.# <br />P013o)l 1180, 60EP $aje, WA yBZSI Phone/Email 36079333ss <br />Address <br />TENANT BUSINESS NAME CONTACT FOR PERMITT I♦ON �G e4612 <br />(10( (z(s05T'LL4r " F,/6wCarr ZA 9QZoe <br />rTY if 7 MOF314 <br />f�Phone/E-mail'7 b•384•z4 4 K1 to ICr L•»t <br />BUILDING PERMIT APPLICATION <br />CONTRACT PRICE OF WORK �o �D <br />GAS, 57471oN/RE«55 e"M • FiOC• HEAT SOURCE: <br />E;..sting Use of Building k <br />Proposed Use of Building 4A&7 Gas_ Electric_ Other_ <br />Building type: Single Family _ Duplex _Townhouse __ Multi -Family X Commercial <br />_ <br />Type of project: _ New _ Addition _ Remodel _ Repair K T.1. _ Sign _Sprinkler _Deniolition_Change of Use <br />Description of Work (additional space provided on the back): Mb Dt F y A K /—a 4,2 C oNJ h•1 VAJ(t47'1 bF.t S <br />FaCtLITS' ay ,QL�L,r1GING r�oV.e Ex•,57-)H4- A,147`Ew-1NAA5 /AND /4PP/N6 Ywo <br />I-/F. c,,! PA NeL ArJ'r"!r ht.V,dS ON T/-% RooF OF AN �fi15 T//-!!n 50ti Pl"&/ ACID <br />Have you started worki„g without a permit? _YES NO <br />MECHANICAL PERMIT APPLICATION <br />PLUMBING PERMIT APPLICATION <br />Type of Project: _New_Addn _Alteration _Repair <br />Type of Project: _New_Addn —Alteration __Repair <br />Show Number 0) cf fixtures <br />Show Number (#) of fixtures <br />A/C — air handling units <br />Toilet <br />Forced air systems <br />Bathtub <br />Lavatory (wash basin) <br />Gas piping <br />Water heater <br />Shower <br />Gas fireplace <br />Kitchen sink & disposal <br />Gas fan a <br />Dishwasher <br />Clothes d er <br />Clothes'warher <br />Ran a hood <br />I Water heater <br />Exhaust fan <br />I Sink (servicelbadmop/elc.) <br />Heat pump <br />I Backflovr lDreventer <br />Unit heater <br />I Urinal <br />Boiler <br />Drinkin Fountain <br />Retngeration <br />I Floor drain <br />Woodstove <br />I Grep.se trap <br />Ducting <br />Roof .rains - <br />Other __ <br />Medical Gas <br />SPRINKLER 1 SUPPRESSION SYSTEM <br />Other: <br />Number of Heads <br />Other: <br />I hereby certify that I have read and examined this application and know the same to be true and correct. All provisions of laws and ordmances governing <br />this type of work will be complied with whether specified herein or not. The granting of a peril does not presume to give authority to violate or cancel <br />the provision of any other state or local law regulating construction or the performance of construction . That I am authorized by the owner of this property <br />to perform the work for which application is made and I comply with the Stale Contractors Law 18 27 RCW and 296.200 WAG <br />Ovmer/Authorized Agent Signature Date <br />.;W'. <br />(Revised nO11) 1 <br />