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{ <br />PERMIT APPLICATION <br />BUILDING/MECHANICAL/PLUMBING/SIGN/SPRINK!�cR/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 />ripe, conu a AM Tn A PM I'D —' "r <br />APPLiCA I iONS ARE ryVx.er , L- , _ . --- - - <br />P,fiRI/IT, # <br />PROPEEER�' TAI(#t <br />SITE ADDRESS: V EVee7.7�-3s6 <br />3120 w� <br />LEGAL for new construction Shoe, Plat/subdivision 'mot No.__ (attach copy of long legal description) <br />r'f�un� l-�u� r�tON T�UA1F-J Phon,1E-ma11 �.-2i:{)�I405 <br />OWNER �f <br />Address 3/2D Ti WI1T>W City/State/Zip <br />APPLICANT: —Owner -11-1�bwner's Ag^nt _Contractor _Contractor's Agent _Tenant lmi,et previoe,knerUm�sem rrom trip ow*eno ao+oM ++Ina+pawl <br />W 6:)'Z 01 Ti2UCW`l L & I Lic # wE cAooB 13 C�OEE Bu-s7. Lic. # <br />CONTRACTOR'T �S'ZJ 9'(Ot/S <br />Phone/Email <br />�I 20 <br />Address `1-�"1 `t ' `" <br />TENANT BUSINESS NAME <br />CONTACT FOR PERMIT f pfQ,E/N(JS 14RC�� <br />TJtofwtS C�h►le-�Kv7iE U <br />A/t,[ah <br />�w <br />PhonelE-mail 21' <br />BUILDING PERMIT APPLICATION <br />CONTRACT PRICE OF WORK <br />d <br />HEAT SOURCE. <br />Existing Use of Building � 1 f( <br />Gas Electric Other <br />Proposed Use of Building/ �� <br />v <br />Building type. Single Family _Duplex _Townhouse _ Multi -Family ? Commercial <br />_ <br />T pe of ro ect New Addition Remodel Repair T.I. Sin Sprinkler Demolition Chan a or Use <br />DESCRIPTION OFWORK Iaddmonalspacepmvidedonthe backl: INiF to ��r Jm0U�t0fNT of <br />SECor� fLD(--F . RF10CM'E WTI" 51�L [K � p- Sa�7fl � 1�►� u ►�I � <br />ct A Ni SFCpN� Lai FAJT S� �LUI► IWo, f}WIG! L16tfRi�i:_ <br />MECHANICAL PERMIT APPLICATION <br />PLUMBING PERMIT APPLICATION <br />Type of Project: _Addn _Alteration _Repair <br />Type of Project: _NOW _Addn _Alteration _Repair <br />_New <br />Show Number (#) of fixtures <br />Show Number (#) of Nxfum, <br />A/C - air handlln units <br />Toilet <br />Bathtub <br />Forced airs stems <br />Lavatory (wash basin) <br />Gas piping <br />Shower <br />Water heater <br />Kitchen sink & disposal <br />I Gas fireplace <br />Dishwasher <br />I Gas range <br />Clothes washer <br />Clothes dryer <br />I Water heater <br />Ran a hood <br />Sink (servicelbar/mop/etcl <br />Exhaust fan <br />I BackBoW preventer <br />Heat pump <br />Urinal <br />Unit heater <br />nrinkina Fountain y <br />Boller <br />Floor drain <br />Refrl eration <br />Grease trap <br />Woodstove <br />Roof arairs <br />Ducting <br />Medical Gas <br />Other <br />SPRINKLER I SUPPRESSION SYSTEM <br />Other. <br />Number of Heads <br />I Other. <br />I hereby cenily that I have read and examined this application and know the same to be true and correct All provisions of laws and ordinances governing this type of work will pip Wr"Pueo <br />With whether pecdied herein or not The granting of a permit does not presume to give authority to violate or cancel the provision of any other state or local law regulating construction <br />That I am eyl onxed by the owner of this properly to perform the work for which application is made and I comply with the Stale Contractors Law I 27 RCW and 296 2dgA WAC. <br />(Revised 62072) <br />