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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.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />Q`_ -1 <br />SITE ADDRESS :'I -Z-7 /yev, I FzKU <br />PROPERTY TAXp1I PE 1T• <br />O 5 /a ODSC�OI <br />L <br />,,Q/ Sl e4.i-TI <br />O No (attach copy of long legal description) <br />LEGAL for new consuuceon: S/fan PlaUsubdlvadon <br />• _Lot <br />LPhone/E-mail <br />GOWNER <br />Xason(erAMnW • Or <br />7�^7' DomY• <br />OL <br />s'Zy <br />Qod <br />Address <br />CilylS[ate/ZipYS%Tj�49�j <br />Conlractot's Agent wneraoonsem from teowwrtoduwnn"vpaa) <br />APPLICANT' Owner k"Owner's Agent _Contractor _ <br />_Tenant(mud,irea <br />L & I Lic. # COE Bus. Lic. # <br />CONTRACTOR <br />Phone/Email <br />Address <br />ENANT BUSINESS NAME <br />CONTACT FOR PERMIT I ��y c 70 _ 6-7O� <br />Tail f G.J <br />5,, _ iW Op 506'10Vr-ii S1 Co. <br />SZIIDY ..J�" �+ <br />r4A'il <br />Phone/E-mail APr1 I-r�i G41"IrI.2I111 1 r7 G�✓1� <br />-the, <br />PRICE OF WORK-L <br />BUILDING PERMIT APPLICATION <br />CONTRACT <br />O 5 2 fiPG� <br />tp HEAT SOURCE: <br />Ewsting Use of Building <br />5 <br />Gas Electric_ Other <br />Proposed Use of Buildi <br />Multi -Family Commercial <br />Building type: _ Single Family _ Duplex _Townhouse _ <br />T.I. Sign Sprinkler Demolition change of Use <br />T pe of ct: New Addition Remodel Repair <br />DESCRIPTION OF WORK (additional space provided on the back): <br />IN car <br />hli'4�e,� for dlr4i� <br />v4�fvtor <br />rh^ <br />1lj <br />� <br />&eet f� &�F}e. Gib c�15e -10 be, <br />"CQ,' be- - pig w <br />PLUMBING PERMIT APPLICATION <br />MECHANICAL PERMIT APPLICATION <br />T of Pr <br />YW _nv <br />N_Addn _Alteration _Repair <br />Type of Project: _New _Adds _Alteration _Repair <br />Show Number bit of fixtures <br />c Show <br />Number (#1 of Rxfurea <br />I Toilet <br />AIC —air handlin units <br />Bathtub <br />Forced airs stems <br />wash basin <br />Gas pipingShower <br />Shower <br />ater heater <br />itchen sink &disposal <br />G fireplace <br />washer <br />Gas e <br />Clot s washer <br />Clothes er <br />Water h ter <br />Rance hood <br />Sink servi bar/mo /etc. <br />Exhaust fan <br />Backflow, prev ter <br />HeatUmp <br />Urinal <br />Unit.. <br />Drinkin Fountain <br />Boiler <br />Floor drain <br />Grease trap <br />W.Refrigeration <br />Woodstove <br />Ductin <br />Roof drains <br />Medical Gas <br />Other <br />1 SUPPRESSION SYSTEM <br />other: <br />SPRINKLER <br />Number of Heads <br />Other: <br />tn, <br />I hereby cedsy tat I have read and examined this application and know the Same to be true and cdmadt. AO provisions of laws and ordinances gdvemmg this type of worK we — coum""' <br />oilhandy, to violate or cancel Me provision of any other state <br />win <br />That am autorri by to /comer of this presume <br />inaptly W ped°nn Me wank foativen Specified reand or not The starting of a permit does no( whJich applicatmade is de and I comply with to State eatm CorrLaw18.27 RCW and 298.2 0A WAC can <br />�1�yC/Date <br />(Revised N2012) <br />rlAr odzed Avont Sig ura <br />t(z- <br />