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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 /> SITE ADDRESS: — PROP tr TYTAx 11 <br /> I ` -61 U'Irg ) rtl0. Q oLIZrdq.3o9o ► ' oc P "I'�*VV J� ' ()'-;— <br /> LLEGAL for new construction: Short Plat/subdtvision Lot No <br /> ,---�� 1 (a[tach copy of tong legal desetiption) <br /> OWNER ' r-'t C.. 110.3_04 01. Phone/E-mail mail 4.2 5 . a � ' n <br /> ,mac 9 (o Q <br /> Address <br /> ,--.. City/State/Zip <br /> APPLICANT: Owner Owner's Agent /Contractor Contractor'sant <br /> A9 _Tenant(must pYrvdcatctteratconsent from the owner toaowork hthe spax) <br /> CONTRACTOR Sr1,,Indy‘...1..4—\ 'State Lie_#;ti q-1 city 0 $a� <br /> Address 01 - � . � C Bus.us.# �+S ,,, 0 <br /> TENA . Phone/Emaillp ,OL `i g ob <br /> CONTACT FOR PERMIT , t 0.o 'i f.t.Y A4'1 <br /> �'� �� Phone/E-nail i Qa rn i-C.,_(5)10( a.N1 l/_P e'A1'Y% <br /> BUILDING PERMIT APPLICATION � <br /> CONTRACT PIRIGEOF WORK c7 <br /> Existing Use of Building <br /> HEAT SOURCE: <br /> Proposed Use of Building Gas Electric Other <br /> Building type: Ingle Family Duplex Townhouse _Multi-Family Commercial <br /> Type of project: New Addition Remodel _ Repair T.I. Sign Sprinkler Demolition Change of Use <br /> DESCRIPTION OF WOR (eddirionaf s ace provided ag the back): <br /> I n 8,11.11 c r 1.-c..?- .4- , 4 F.' rf <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type of Project: New Add ,.Alteration_Repair Type of Project ,New Arkin Alteration_Repair <br /> Show Number of fixtures Show Number(#)of fixtures <br /> A/C—air hand lin: units --..„ Toilet <br /> Forced air systems Bathtub <br /> Gas .i.iri Lavator�(wash basin) .._.i <br /> Water heater Shower <br /> Gas fireplace Kitchen sink&disposal t <br /> Gas range <br /> Dishwasher <br /> Clothes dryer Clothes washer • <br /> Range hood <br /> Exhaust fan Water heater <br /> Heat pump Sink(service/bar/ etc. <br /> Unit heater I Backflow preventer <br /> Boiler Urinal <br /> Refri.er�tion Drinking Fountain <br /> Woodstdve — Floor drain <br /> DuctingGrease trap <br /> _ <br /> Other _ Roof drains <br /> SPRINKLER/SUPPRESSION SYSTEM MBdioat Gas <br /> Other: <br /> Number of Heads Oilier: <br /> • <br /> I hereµb*y certify that 1 hava read and...mined thisapplication <br /> &I permit <br /> and know the earns to be bue and correct All provisions of law,end ordinances g typo or wont will be corn <br /> specified herein or not_The droolingdoes not prtasurne to er State or looal saw regulating onrceP <br /> nln the <br /> give aulhonty to violate or cancel they p <br /> I am auihortred by the own•r of this property to perform the work for ,ich ep. tion ia made and I comply with the State Contractors Law 7927 RCW and 20200A WAC oiler <br /> A AAA ., `tl�`� / q <br /> nor/AUtti•nzed Agent gipnature <br /> Date (Revised 9/2014) <br /> ilei5-, Qt <br /> .> <br />