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PERMIT APPLICATION <br /> BUILDIN r. MECHANICA PLUMBING/SIGN/SPRINKLER/DEMOLITION <br /> CITY OF EVERETF PERMIT SERVICES <br /> 3200 Cedar St, Everett,WA 95201 425-257-8810 FAX 425-2578857 www.everettwa.org <br /> er'rE ADDRESS: 7(iI 14 <br /> �ev�,r' e 1 v; Poo "3-00'o, Z oS l 42-06 .-- <br /> LEGAL for neer construction: Shan Plattsubthvhion ....•. _ i.ot No .(attach copy of long legal description) <br /> • <br /> OWNER tko.erfie. ohor Phorlsll� all (i.2 ,S 3SO- o73 <br /> . ?ci I Z - J'r� 1st aalstcterxtp - r -'("f wA etS2o3 <br /> Ai'PUCANT:Owner , Owneee Agent _&ConhzacFor Contr'aoto?s Agent Tenant(must emulate lottoof owserd Sem Se merino doen&Who mess) <br /> mem, . <br /> CONTRACTOR ‘S/'l! 02,4 AiY r./.:I',i,` /����3SState Lie # l t1M4 /4_ /7/a/ 'C-, Bus.I.I.# 0 53 ' A <br /> •••rays I"ou A Oar s Ela k t i lima l•42 q6 o, 'Rime/Erna .co '7i ei mut 1' 1,G ' <br /> • , <br /> yi , I . . <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK - q t'h?.o 0 <br /> ' Ed ding Use of Building HEAT SOURCE; <br /> Proposed Use of Bu+idin. Gas Electric Other, <br /> Building type: .-.,_.Single Family Duplex Townhouse —Multi-Family _Commercial <br /> Type of project New Addition Remodel Repair T-l_ S,n •rinkler Demolition Chan! of Use . <br /> DESCRIPTION OF WORK fade space provided on the hack:. kelY)Otik ElPia'U— Wad— <br /> Ive1/vim y __ -.•� apicr �V) <br /> • <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type of Project: _tow Addn.Alteration Repair 4. Type of Project _New_,Aiidn_Alteration Repair <br /> Show Number L; of fixtures •_, • OA' t 1 Show Number U of'brumes <br /> • AFC--air hendiln• units T. _ <br /> Forced air a .terns i riathwb <br /> — GaS G . -1 , La = wash basin <br /> L . Water heater • _ Shower - <br /> 1 Gas fireplace .... Kitchen sink&die•osal ._ <br /> Gas ra .- Dishwasher <br /> — <br /> Clothe ler Clothes washer <br /> 7 Range hood * water heater <br /> Exhaust fan ? Sink jaeM c olbarlmop/etc.) --""------7 <br /> I haat•um. -- Backflow•revenler . <br /> IIMIIIIIIIII Unit heater . Urinal <br /> Boiler - ' j 0 ' ! Fountain ., <br /> ••••• <br /> I Reil.eration Floor drain <br /> Woodstove i Grease tray <br /> Du. Roof drain <br /> Other _ Medical Gas _ <br /> SPRINKLER/SUPPRESSION SYSTEM i Other <br /> Number of Heads : Other _ <br /> . <br /> I hereby eel ey Ihet l have mad and e> ed thiseggroffen and know the sante to be true end corm&All plwIaIone diens and ordtniels s governing tela type of wotk et he comet <br /> Tits whether herein or not The granting of a pent daes dotpreaume to give mem*to violate or Cantel the provider'of any other state Or local law regulating coretrumon <br /> Theti em edict by the owner of this property perform the work forwhWi application's credo and i comply with the State COMMONS LAW 1a23 ROW told 298.200A wee, <br /> 2i <br /> 2/1016 <br /> Owner/Authorised Agent mese. De* 1.,.))6.(.0 9, (Revised 9/2014) <br />