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PERMIT APPLICATION <br /> BUILDIN 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 wNw_everettwa.org ' <br /> SITE AVM" • '. , 4PPROPERTY TAX# PQ IVIrr" - U+ r- <br /> rlr 1 __ I _ . <br /> LEGAL for new construction- 6itort Ptatisubdiviaion -. Lot No. (attach copy of on !mall des ption) .• <br /> ,\ <br /> OWNER , /1 CSL( I sc2 e5 Phone/E-mail L - 2-/l)` 'c <br /> SJ 3 <br /> r4ddfeso 1 u <br /> J I 5 Cly/StAtefZ1A J W/ y�i <br /> APPLICANT:-Owner Owners Agent X Contractor Contractors Act —Tenant line.provkIe a rcfconsau from the owe&to do„v:sc to to&) <br /> ihriommw <br /> CONTRACTOR ash tali tLIIY lc, state Lic.# 464- /--/I • '! / 'City Bus.Lic.#r` D 53 ' d <br /> Address /kb() /ICht.Y/ s frit k A i 16 LL� �rr 7 <br /> Gq 0, Phor <br /> i ,Cb 1 f-0eg-0ekva.ttltt ,vIC, <br /> m '1`—BUSINE. 1rr :E COMM ,,//i; PERMIT <br /> Phone/E-mail )4."00 P117.:1:6/F <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK, 1 (20,°() <br /> Existing Use of Building HEAT SOURCE: <br /> Proposed Use of Build • Gas Electric ,,, Outer <br /> Building type: Single Family Duplex Townhouse ,Multi-Family _Commercial <br /> Tj•- of•rcect New Addition Remodel R:•-ir T_4_ Sian Sarinkler Demolition Chan••• of Use <br /> DESCRIPTION OF WORK(additional space provided on the back): a ( , <br /> • <br /> keirylotcfr aplav_ I a& , <br /> ......,„ A.,a,),/,.,- (sj <br /> . . <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Typo of Project _New Adtin _/alteration Repair Type of Projoct _Nevi Addn _Alteration Ropalr <br /> Show Number 0)of fixtures K kr PkfU-e►her.,t Show Number(()of fixtures <br /> 1 <br /> NC-air handliniunits i Toilet <br /> Forced air systems Bathtub <br /> Gas piping _ , Lavatory(wash basin) <br /> I # Water heater __ Shower <br /> Gas fireplace _ ! Kitchen sink&disposal <br /> Gas range Dishwasher <br /> Clothes dr'or j Clothes washer - <br /> '^ <br /> -t Rs •e hood Water heater <br /> i Exhaust fan 1 Sinklierviceibarlmopiotc.) <br /> i Heat pump Backflow•reventer <br /> Unit heater Urinal <br /> I _ Bailer Drinking Fountain <br /> Refrigeration I Floor drain <br /> Woodstove _ Grease trap <br /> Ducting Roof drains <br /> Other Medical Gas <br /> SPRINKLER / SUPPRESSION SYSTEM Other <br /> I Number of Hsad3 i Other. <br /> I fieretty certify that I have read and examined thin np•pattillon and know the Seine to be true and correct An prnvldans of taws and ortltnancea govaming this type of work ttf be Comp! <br /> Will whether spectr,ad herein or not The granting of a permit does not presume to give authorey to vloSate or cancel the provtafon of any athor sista or local law tIviudatvsg corn wmton <br /> That I,.. . a .rr:.b the owner of Otis property to rfocm the work forwhich apokpfion is made end I o mpy withthe State Contractor;Law 18.27 RCW and 246.21aa WAC_ <br /> Ownser/Authoriz( Agarrt stgnantre (f Date (Revised 3/2014) <br />