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FERMIT APPUCATION <br />BUILDING/MFG' IANIGALIPLIJMUING/SIGN/SFIR INK1.-FR/f)FM11 0 LITION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 Cedar St., Everett, WA 98201 425-257-8810 FAX 425-257-8857 wirmeverettwa.Drg <br />SITE ADDRESS: �,-'II <br />4�7A <br />PIiOPERTY TAxd <br />PE 11T aY <br />LEGAL for new ccnsirucimn. 5horl Plal/sublI vislon Lot No._ of Ibnn�g legal description) <br />OWNER L,fL�f(%� Ouvt' <br />/-(att1a1c-h�corypy <br />Phonel&rnad C(0`�I ��-f`��'f� <br />Address �- W/ <br />r� <br />CitylStatc2ip �tt. >i <br />_ <br />APPLICANT:_Owrer _Orin is Agent �Conimctor _Contractor's Agent _Tenant(m.,slprorlds a Icecrct consam ftmcne enner10 dP epacc) <br />n hhh <br />City Bus. Lic. i! 05 <br />/lI� <br />CONTRACTOR f'�O FJ'(IK "� �� State Lic. # <br />Address �, , ✓� /Yl?'1J' lit' �^ Phonc/Ema,l or b �CS77 e, y <br />C <br />CONTACT FOR 1; IT -tiL <br />�jPERMIT <br />,// <br />PhD"/E-mail <br />BUILDING PERMIT APPLICATION <br />CONTRACT PRICE OF WORK_._ - <br />HEAT SOURCE: <br />Existing Use of Building _ <br />Proposed Use of Building Gas_- Electric_ Olher_ _ <br />Building type: XS ingle Family _Duplex _Townhouse —Multi-Family _,Commercial <br />Type of project: _New ,Addition _Remodel Repair K T.I. Sign Sprinkler _Demolition Change of Use <br />DESCRIPTION OFFWORK (additional space Provided Onthe back) : _ ��. L�,II <br />, heofe-I <br />cK�c7a-i-�s' <br />MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br />Type of Project: _New_Addn _Allemtion_Repair <br />Type of Project: _-New _Addn Alteration _Repair <br />Show Number (4) of ra(I <br />Show Number(N) or fixtures <br />A/C —air handling units <br />Toilet <br />Forced air systems <br />Bathtub <br />Lavatory (wash basin) <br />Gas piping <br />( Shower <br />Water heater <br />Kitchen sink 8 disposal <br />Gas fireplace <br />Dishwasher <br />Gas range <br />Clothes dryer <br />_ <br />Clothes washer <br />Range hood <br />Range <br />Water heater <br />-- <br />l fan <br />ExhauHeat <br />Sink (service/bar/mo ILIC. <br />—� <br />-- <br />i;eekgelrpreventer (Inside bidg) <br />pump _ <br />Urinal <br />_ <br />Unit healer _ <br />_ <br />Drinking Fountain <br />Boiler <br />Refrigeration <br />_ <br />Floor drain <br />_( <br />Woodstove <br />_ <br />Grease trap <br />Ducting <br />—� <br />Roof drains <br />Olhcr, <br />Medical Gas <br />SPRINKLER / SUPPRESSION SYSTEM <br />_ <br />I <br />Other: <br />Other: t3CCGFC f/ <br />Number of Heads _ <br />I hemby unify Thal I have mad and examined this application and know the same to be true and conect. Ail provisions of laws and ordinances governing Ibis type of work will be complied <br />with wbether spedfed herein or not. The granting of a permil does not presume to give aubonty to violate or cancel the provision of any other state a local law regulaling consimcilon <br />That l amnu orhed bythe owner of lh to perform the work for which Opp) iraOonls made and lcomply with the Slate Contractors law 19.27 RLW and 298AC. 200A W <br />0,ne aW,,dASn Signature <br />Date (Revised 4/2015) <br />