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PERMITA-P_• ICATION <br /> BUILDING/MECHANICA 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: ITS <br /> t r PROPERTY TAX#! <br /> 20l /r9,�, & Ave 0(2 01 $q I7oz3ooIJ2 - O2)� - <br /> LEGAL for new construction: Short Plst/aubdivieien Lot No, (attach copy of long legal description) <br /> OWNER t3. 5 i,.4 t I , Phone/E-mail - �/t <br /> Address 2.4.)44 VC(r-,51'n;A 4 e Cib/Stete/Z'tp E /e etto '..vA q (2z0( <br /> APPLICANT:_Owner Owner's Agent / -Contractor T Contractor's Agent Tenant(mire provide/loaner ot consent from a10 owner to(to WA it ate ayaw) <br /> CONTRACTO/R 1i(JC�/$h f7 Wal--LV /kte / Ida <br /> Liic.# 1,o1-51--/_,/A it- d�I7u p{��City Bus,Lic.# 0�3 <br /> 1-119 <br /> Address (?VV Cltr!.f.rrd5 fit. 5'` Al ^ G N.L v'-'�` /0Qi0,5Phone/Email t /f 8 yeF WaL/+t" ke;M <br /> TENANT B1JSINE S NAME f CONTACTFOR PERMIT ✓ <br /> Boa—°P.-§11:2gif • <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK (too,- ov _ <br /> Existing Use of Building eA5. • <br /> GI(;t HEAT SOURCE: <br /> Proposed Use of Building _ Gas Electric Other <br /> Building type: Single Family Duplex Townhouse Multi-Family Commercial <br /> ,Type of proiect: New Add tion Remodel Repair 7.1_ Sign Sprinkler_DemolitionChange of Use _ <br /> DESCRIPTION OF WORK(additions)space pravizied on the back) <br /> klQ,MOVf ° a_a —e /—eCM Ci it�ig)t'-e A-tale/7. <br /> ("5' <br /> MECHANICAL PERMIT APPLICATION I PLUMBING PERMIT APPLICATION 1 <br /> Type of Project New_Adeln Alteration_Repair Type of Project _New_!(ddn _Aiteratton Regal <br /> Show Number(`0:)Of fixt4u•es show Number(#)of fixtures 14 e <br /> A/C—air handling units I Toilet <br /> Forced air sJsterns _ i Bathtub <br /> 08s piping m Lavatory(wash basin) <br /> Water heater Shower <br /> Gas fireplace _ Kitchen sink&disposal <br /> Gas range _ _ _ _ Dishwasher <br /> Clothes dryer - Clothes washer <br /> Range hood - I Water heater <br /> Exhaust fan ] Sink(service/bar/mop/etc.) <br /> Heat pump Backflow preventer <br /> { Unit heater Urinal <br /> Boiler Drinking Fountain <br /> Refrigeration ? Floor drain <br /> Woodstove Grease tra, - <br /> Ducting _Roof drains <br /> Other i Medical Gas <br /> SPRINKLER I SUPPRESSION SYSTEM <br /> Other: <br /> Number of Heads : Other. <br /> I hereby cartery that I have react and axarnIned this approation and ivlow the same to De Rue and correct.A:provisions of taws attct eminences governing this type of work MI be comp <br /> with Woollier speclled heruln or not.Ttte granting of a perm«(tows not presume to give authority to vtotate or cancel the provision of any otter state or lows saw regutaling construction <br /> That I am eu ortzed by the owner of this property o perform the work for which appachtlon Is made and I comply with the State Contraflow:Law 18.27 RGW ttn5 2 a 2OOA WAG. <br /> • , A D- 1—/ /( <br /> Owner/Authorized Agent Signature - Daft <br /> (Revised 9/2014) <br />