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0 0 <br /> PERMIT APPLICATION <br /> BUILDING/MECHANICAL/PLUMBING/SIGNISPRINKLERIDEMOLIIION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 Cedar St,, Everett, WA 08201 425-257-8810 FAX 425-257-8857 Www.eve rettvra.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO d PM <br /> SITE ADDRESS: Y�20 a aapi err Tax p Pir c� 0�4 it <br /> LEGAL for new construction: Short Plat,'subdivisdon _ Lot No. <br /> (attach wopy of[off ai'descripiion) <br /> OWNER Phan! <br /> E-mail <br /> Address _ C 'Stata?Z;p <br /> APPLLICANT: ..Dvner ___Owner's Agent _Contractor —Contractor's Agent T' non€�rsus' Hca Arr�ryae;?tfcnL4ec es daerRin.hasaacej <br /> CONTRACTOR � �q �* jt�} i,�r�S35fGct"�{041 L�1!_Ic:# CTtQ0KS�J?77h-4tOEBus.L1c.* 0520-D <br /> dress - , ` ' Fh--ne,Emai t,SatYu iz`7 7Z e7 y+�•�4d. <br /> TENANT BUSINESS-17—ME CONTACT FOR PERMIT <br /> � Z- <br /> Phone,,'E-mail -Z,6— 3L3— 4 86 <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK 14900> -r <br /> Existing Use of Building HE-AT SOURCE:Proposed Use of Building Gas ���t tG t?t ar <br /> Building type_ _Single Family>(-Duplex_Townhouse _Mufti-Family —Commercial <br /> Type ofproject: New Addition Remodel Repair v T.#.__Sin S rimer Demalifion Chan e of Use <br /> DESCRIPTION OF WORK(addlticviat space provided on 9h Dacsk): <br /> jc sk"..tS ISS <br /> i49 CHANICAL PERMIT APPLICATION t�1.5,1MBIN PERMIT APPLICATION <br /> Type of Protect: _Now_Addn �Alteration,_Repair Type of6�rOJt:Ct: ,_,,,_New_Addn —Alteration Repair <br /> Show Nurnber(4)of fixtures Show Number(#)of fTxturee <br /> A/C.-air handling units Toilet <br /> Forced airs stems Bathtub <br /> Gas piping Lavatory(wash basin) <br /> Water heater <br /> Shotiver <br /> Gas fireplace E Kitchen sink&disposal <br /> Goa rangeDishwasher <br /> Clothes dryer Clcthes washer <br /> Range hood j Water theater <br /> Exhaust fart i Sink(sect br�� o(eto, <br /> Heat pump j Backflow preventer <br /> Und heater t Uncial <br /> Boiler i Drinking Fountain <br /> Refrigeration Floor drain <br /> kVacdstoveraase tra <br /> Ducting Roof drains <br /> Other Vedical Gas <br /> �SPRINKLIERSUPPRESSIO `SYTfumber of Heads Other: <br /> I hereby certi!y that i have w-d and oxamoad thm appl;cxt�on and krro4v the sante in be true and correct.All provisions of it and ordinances gove4rning.this 1 4yl c of�vcrk vr,"ti,e complied <br /> vvRh s,ito er spsdttkad hAMin or not.The granting of a perntt does not preseirrta to ghe aulttcrify to violate or cancel the provis;on of any other siate o,irrai Laft regulating consimction <br /> That!am this properly to perform the work for which appitcaton Is made and t compry wilh tare Slate Contractors Lavv 16,27 RCW and 298:200A WAC. <br /> OwneriAuthorized Agent Signature Date (Revised 812092) <br />