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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 /> SITE ADDRESS: 'l. ;5- n PROPERTYTAX# <br /> r i <br /> LEGAL for new construction: Short Plat/subdivision FPlat/subdivisionion _ Lot No. (attach copy of long legal description) <br /> n <br /> OWNER �i''T/ _1 1VA)" Vcs. PhonelE-mall <br /> Address City/State/ZJp <br /> APPLICANT:r Owner owner's Agent ,Contractor Contractor's Agent _Tenant Imust provide critter ofcorua,t born the maw to do work In am space) <br /> CONTRACTOR -2G 0 u.) Co k• t"fo pL 8 I Lic.# , * TN 11'1Z£OE Bus.Lia# <br /> ✓ <br /> Address I- r Ng-- '15 4'4' y I [r/$5 Phona/Erttafl ) O4'— 3 t 3 -5a.g r <br /> TENANT> USINESS;NAME ~ CONTACT FOR P ' 1 /.�/ <br /> Phone/E-mail e-S-c^-y (� 4) , Cr u•Z "' nmi-N10e Pori.•er4 <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK _ t1.gO0-oG <br /> Existing Use of Building HEAT SOURCE: <br /> Proposed Use of Building Gas Electric Other <br /> Building type: _Single 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 WORK(additional space provided on the back): <br /> '-171ZS; r Of /-z*►Iny VO0c Nee__ Skt X and tng`c-q1 <br /> Jrt�w C2w/PoTt 4" ;on SH .tS1Q S <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> —. . <br /> - Type of Project: _New,_ ,lddn _Alteration Repair Type of Project; New_Addn _Alteration Repair <br /> Show Number(#)of fixtures Show Number(#)of thftures <br /> A/C—air handling units Toilet <br /> Forced air systems Bathtub <br /> - Gapiping Lavatory(wash basin) <br /> water heater _ Shower <br /> Gas fireplace Kitchen sink&disposal __ <br /> Gas range Dishwasher <br /> Clothes dryer Clothes washer <br /> Ranje hood Water heater <br /> Exhaust fan Sink(service/bar/mop/etc.) <br /> . Heat pump Backflow prover�_ter <br /> Unit heater Urinal _ <br /> Boller _ DrinkinQ Fountain <br /> Refrigeration _ Floor drain <br /> Woodstove Grease trap <br /> Ductirts _ Roof drains <br /> Other Medical Gas <br /> SPRINKLER/SUPPRESSION SYSTEM Other. <br /> Number of Heads Other; <br /> I hereby certify thot I have read and examined this oppllwtion end know the some to be true and correct.AA provisions or laws and ordinances governing this typo of work will be compiled <br /> with whetner ep d herein or not,The wanting of a permit deea not presume to give authoilty to violate or cancel the provision of any other stale or local law Mutating conatnrction <br /> That I am a the owner of this property to perform be work for which epplmtion is made and I comply with th■State Contractors law 18.27 RCW and 29e,200A WAC, <br /> esui_ o c'ii6/13 <br /> Owner/Authorized Agent Signature Cate (Rcvlse#6/2072) <br />