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• <br /> PPRMIT.APPLICATIO N <br /> BUILDING/MECHANICAUPLUMBING/SIGN/SPRINKLER/DEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 Cedar St., Everett, WA 98201 425-257-8810 FAX 425-257-8857 wt+wrw.everettwa.org <br /> SITE ADDRESS;/ <br /> ST, 131P7IriZ#0./D Waal nig14641. Ali. <br /> LEGmL*r�neww construction: Short Plat/subdivision Let Neu_ (attach copydylmup 1pil da <br /> OWNERr�l 7 ATM/6 Phone/E-mail l�i� '► I Qf drdi .• <br /> Address 347 7 49 ' ,4 -wZ '— City/State/Zip j oi <br /> APPLICAN17er _Owner's Agent _Contractor _Contractor's Agent _Tenant onsessallieeeintemeleaseisesswisesameaseespiee <br /> CONTRACTOR State Lic. # City Bus.Lac* <br /> Address _ Phone/Email • <br /> TENANT <br /> 7BUSINESS NAME CONTACT FORLOPERMIT 4���a►z•,90" /� <br /> 7L 1'—or✓ , ,� Phone,E-mail/75 /63000.406090" <br /> 3?9 'd i 0,V <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK AL�27 044)•4111, <br /> Existing Use of Building HEAT SOURCE , <br /> Proposed Use of Building �- Gas .!Elecirk 17 Other <br /> Building type: Single Family _Duplex_Townhouse M✓ iti-Family _Commercial <br /> Type of project New Addition _Remodel V Flilmeir_T.I._Sign_Spnnkler Demolition Change of Use <br /> DESCRIPTIOJV OF WnRV / • el en ce provided on the <br /> d fe•vooGc1 + lF� t 401:4- of <br /> 'kms 6A, ./6D(E` id .wodo$# • :'• <br /> l 7//.0tr 4/li✓G <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type of Project: Type of Project: _New_Addn _Alteration_Repair <br /> Show Number(19 afadures Show Number(1)of fixtures <br /> • Toilet <br /> - <br /> Forced air s stems Bathtub <br /> Gas piping Lavatory(wash basin) <br /> Water heater Shower <br /> Gas fireplace Kitchen sink&disposal <br /> Gas range Dishwasher <br /> Clothes d er Clothes washer <br /> Range hood Waw <br /> Exhaust fan SiNC'(seret /bar/mop/etc.) <br /> Heat pump Backflow preventer <br /> Unit heater Urinal <br /> BoilerDrinkingfountain <br /> Refri•eration Floor dab <br /> .-+tove I G - <br /> •7"-- 11111 Roo drains <br /> Medical Gas <br /> SPRINKLER ZIPRESSION SYSTEM Other. <br /> L ----etanits _ Other <br /> I hereby certify tOlflatea read and examined this applicall11111111011111111the same to be tralland correct.AI provisions or lees and ordinances governing lrypaorwa* <br /> billilibill <br /> with whether spared herein or not.Tile granting of a pen7*INS .111.Me to gpeOallgilly to violate or cancel the proellalge any otherailaior local Isle regulating octoroers _ <br /> That I am authorized by the owner of 00 property to perform V» 1laaQe and I comply with the SIdgeglaractors Law*27 RCVUtlsdampatlme. <br /> fie,.../frof 4:11, <br /> elf <br /> Signature (Revised 3/2013) <br />