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0PER 0 <br /> MIT APPL�CATIOI4 <br /> BUILDING/MECHANICAL/PLUMBING/SIGN/SPRINKLER/DEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 Cedar St., Everett, WA 98201 425-257-8810 FAX 425-257-8857 www_everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> SITE ADDRESS: PROPERTY TAX 9t PEPMI7 , <br /> p Lckriynex- =d �, �Lr_� �; <br /> LEGAL for new construction: Short Plat/subdivlslon Lot No. (attach copy of long legal description) <br /> OWNER W1"\CvR Phone/E-mail LOS--4$5---01 f1 <br /> Address Lav'\fnex- 'R6 clty/statolzip Eti-Gr'eA+ w-p <br /> APPLICANT:—Owner _Owner's Agent V Contractor Contractor's Agent —Tenant fm�+pro�hde a latter of consentr om the owner to ao wen In the epsce) <br /> CONTRACTOR L& I Lic, NU—'Z 0-0)0l I I Cl <br /> OE Bus. Lia# <br /> aVO­15 <br /> Address \-7(,p� " u,*c [Cj1P fV � ihone/Emlld �A <br /> S"76NERG aCOY <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT }l4 V 1 S�t <br /> Phone/E-mallC A 1C C(j(ZNEaS?ONEt200FIN(:4 C - <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORKf C '"5' <br /> , 06 <br /> Existing Use of Building HEAT SOURCE: <br /> Proposed Use of Building_ Gas Eloctrlc Other <br /> Building type; ✓ Single Family ^Duplex__ awnhouse _Multi-Family _Commercial <br /> T e of ro ect: New Addltlon Remodel Repair T.t. Sin S rinkler Demolition Chan e of Use <br /> DESCRIPTION OF WORK(edditiona)spacerov/ded on the back); <br /> Y�rv�o\re r�,,c1" l " r Gcom�s lb�'s►l I� a O'CA t n it l► he w c Pa�;- an <br /> S�o-x 1 es, c 1 <br /> MECHANICAL PERMIT APPLICATION PLUMBING PIERMIT APPLICATION <br /> Type of project: _Now__4ddn —Alteration_Repair Type of Project: ,Now__4ddn _„Alteration—Repair <br /> Show NUMher(#)of fixtures Snow Number t{ of fixtures <br /> A/C—air handlIng units Toilet <br /> Forced airs stems Bathtub <br /> Gas piping Lavatory wash basin) <br /> Water heater Shower <br /> Gas fireplace Kitchen sink&disposal <br /> Gas ran2e Dishwasher <br /> Clothes dryer Clothes washer <br /> Range hood Water heater <br /> Exhaust fan Sink service/bar/mo /eta <br /> Heat pump Backflow preventer <br /> Unit heater Urinal <br /> Boiler Drinking Fountain <br /> Refrigeration Floor drain <br /> Woodstove Grease trap <br /> Ducting Roof drains <br /> Other Medical Gas <br /> SPRINKLER / SUPPRESSION SYSTEM Other. <br /> Number of Heads Other: <br /> I horeby certify that I havo read and examined this appli"tlon And know the same to be true and correct.All provisions of laws and ordinanCaa goveming this type of work will be complied <br /> with whother apecified hrlroin or not.The granting of a permit does not presume to give authorlty to violato or cancel the provlsfon of any other^•late or local law regulsting constructlon <br /> That I am authorized by the owner of this property to perform the work for whioh oppliontion la mado and I comply with the State Contractors t.aw 15,27 RCW and 296.200A WAC. <br /> vGner/A�, ri, <br /> tl ggent 3lgnaturo Oate (Reviaed&?012) <br />