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PERMIT APPLICATION <br /> BUILDINGIMECHANICA PLUMBING/ iGNIS PRINKLERMEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES ' <br /> 3200 Cedar St., Everett, WA 88201 425257-8840 FAX 425-257-8857 www.everettwa.org <br /> SITE ADDRES8c r PRQPER TAX p n <br /> LEGAL for new constuction: Short PlaVeubdivieion Lot No. (attach copy of tong legal description) <br /> t <br /> OWNER rn PhortelE-frtail Z� / �" �� <br /> ddres911A il —2�j <br /> City/StaI921A �V Z C� <br /> PL.ICANT: Owner _Owner's Agent Contractor _Contractor's Agent _Tenant(rmtat provides tartnf of cnotnu from the mwwtn do,.aAc c,the spam) <br /> CONTRACTOR hlaSh! Vea, state L1i;.# Ci Bus. Iic,# 0 <br /> Wk AJ 5/3C <br /> Address jjFVV ooU PhxelEnail (07W � lyj <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT <br /> J a_CV <br /> Phone/E.-m011 <br /> 13UILVING PERMIT APPLICATION CONTRACT PRICE OF WORK <br /> Existing Use of Building _ HEAT SOURCE: <br /> Proposed Use of Building Gas Eiec41c other <br /> Building type: _Single Family Duplex -FamilyTownhouse __ Muni _Commercial <br /> Type Of propaa New Addition Remodel Repair T.1_ Sin sprinkler Demolitio Cha a of Use <br /> WSCRIPTION OF WORK(add&onai apace prnvfd6d on tfle back): <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPI;ICATION <br /> TYAe,of PrOjOa _New Atidn _„_,Alteration_Repair Type of Project Now , dddn Alteration R it <br /> Show Number of fvrfurgs Show Number of ffktufes r <br /> AEC--air handling units Toilet <br /> Forced air S terns Bathtub <br /> Gee pipingi Lflvr3t w8sh basin <br /> Water heater ? Shower <br /> Gas fire lace i Kitchen sink&cliWo,,al <br /> i Gas range Dishwasher <br /> Clothes dryer Clothes wbsher <br /> Range hood 0 7 Water heate it <br /> Exhaust fan Sink setvice/barhno etc_ <br /> Heat purnpBackflow reverter <br /> Unit heater Urinal <br /> Boiler Drinking Fountain <br /> Refri amtion Floor drain <br /> Woodstove Grease trap <br /> Ducting hoof drains <br /> Other -Medical as <br /> SPRINKLER 1 SUPPRESSION SYSTEM other: <br /> i <br /> Number of Heads Other: <br /> 1 hereby cerd y &1 l have read and examined this appkatian and]mow the;amu to be true and coned All provisions of IQv+s and ordhtanupe goventheg this type of work wit be c wnpl <br /> with Win spgdtlad hemm or not The grantu g of a pelma duet not pmzumo to give authondy to violate or cants)the provision of any other=to or bm�Ian regulating Construction <br /> Ttrat effid by the 7 noro is propertir i9 perform the work forwhkli apprcatien is mxda And l oompky wit11 the State ConL3ctom Law 18.27 RCW and 2862=A WAC. <br /> Owner[Authorind Agorit Sigh=r4 <br /> {Revfs®d sF2014) <br />