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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 www.everettwa.Grg <br />4-1'3-i <br />SITE ADDRESS: � 1 <br />O 4N 5� W <br />PROPERTY TAX a <br />P RMIT a <br />LEGAL for new consirucbon Shon PlaVsuborwswn__ Lot No (attach cop/ of long legal descnphonl <br />OWNER p Dry• >1 S uD <br />Phone/E-melt 1-77- 711- joocD <br />Address ;t3?0 ♦i­•fo-iyl• <br />Gty/State/Z,p EJGrciA t.JA qFZ01 <br />APPLICANT: Owner Uwner's Agenl _._Contractor Certraclois Agent Tenam brynpmmaaewna WmnsMi eon iM weer bee woilnNe sD+rtl <br />CONTRACTOR <br />State Lic fl City Bus. Lic. p <br />Addmss phouefFinad <br />TENANT BUSINESS NAME <br />5 nrr41PInonarE-ma,l <br />CONTACT FOR PERMIT C. V A h S <br />1�D �OHLc �i.Af� <br />.25-j2-$ 27 r'C•K.^Sr'ony..\ <br />BUILDING PERMIT APPLICATION <br />CONTRACT PRICE OF WORK___ Q 0+000- _ <br />Existing Use of Budding HEAT SOURCE <br />Proposed Use of Building Gas_ Electric Other <br />Building type. _ Single Family _ Duplex _Townhouse _ Multi•Farni y��[f Commercial <br />T pe d( pro ea New Addition Remodel Re air T I Si n . Sprinkler Demolition Change of Use <br />DESCRIPTION OF WORK (addhonal space provided on the back) <br />�.EP1c�sN6 (3) t�rnoJF-O A�Trv%v'%:s, ADD(37 RR\Ar uvn•ts r`aAord <br />REPLACE wTr:-• A»xcaeu'. -to be <br />MECHANICAL PERMIT APPLICATION <br />PLUMBING PERMIT APPLICATION <br />Typo of Pro)ocl: _Now_Addn _Alteration —Repair <br />Show Number (a) of fixtures <br />Typo of Project: _Now_Addn _Alterallon_Repair <br />Show Number (a) of fixtures <br />A/C — air handling units <br />Toilet <br />I Forced airs stems <br />Bathtub <br />Gas i m <br />Lavatorywash basin <br />Water heater <br />Shower <br />Gas fireplace <br />Kitchen sink 8 disposal <br />Gas range <br />Dishwasher <br />I Clothes dryer <br />Clothes washer <br />Ran a hood <br />Water healer <br />Exhaust lan <br />Sink service/bar/mopletc ) <br />Heal pump <br />Backgow prevenler <br />Unit heater <br />Urinal <br />Boiler <br />Drinkin Fountain <br />I <br />Refrigeration <br />Floor dram <br />Woodstove <br />Grease trap <br />Dudm <br />Roof drains <br />Other_ <br />I <br />Medical Gas <br />SPRINKLER <br />I SUPPRESSION SYSTEM <br />Other. <br />Number of Heads <br />Other. <br />1 hereby Certify Nat 1 have mad and esamined this appxcatxm and know the same to be We and correct AN promons of taws and ordinanus governing inn type of won W1 to Worpked <br />wdh whether specified herein or not The granting of a permit does not presume to give Ael" to violate or cancer the provision of my other stale 01 local fey Milulatng ddnswciion <br />That �aed ",o probe to perform the work for whch apP is made and I comply, with Me Stale Cmtrleora law 1821 RCW and M 200A WAC <br />4- <br />(Revised "017) <br />