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PERMIT APPLICATION <br /> BUILDING/MECWANICA PLUhMi 1NG/ IGN/SPRINKLER/DEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 Cedar St., Everett, WA 88201 425-257-8810 FAX 425-257-8857 www.everettwa.org <br /> sly ADDRESS: 111 23r Ave, W o PIMTs 0( W LSOO' Pliva-1111 -ocil <br /> LEGAL for now conutrucbon_ Short PLVt/aubdiwAun Lot No. (attach copy of fong legal deterpiton) <br /> OWNER �>r�T(e NQS Phone/E_mail �S I 3 d z1 <br /> Address Lfq[ Q 2 rd AvC, icity/Stateop e <br /> APPLICANT: Owner —Owner's Agent Contractor _____Contract&s Agent _Tenant(m+ni pre ma a tetmr of MnM'd rom the mww io Co t ork in the=") <br /> coNTPAcToR Q5hl mil-c v � to ci .Bus:tjc_# 0 O <br /> ddress /LY60 lC ar S &Ifk.A, Fie tj&W a�l 9Lr6 Ptwna(EmaH rb 7Q--09Y WkkJ Irae0'c <br /> TENANT BUSINESS NAMIE COW:7R PERNHT <br /> PhonefE-mailVQQ <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE Of WORK �l�f/'00 <br /> Existing Use of Building HEAT SOURCE: <br /> Proposed Use of Building_ Gas Sectric Other <br /> Building type: _Single Family _Duplex Townhouse Muld-Family _Commercial <br /> Type of prolea New Addltlon Remodel Repair._T.I. Sin sprinkler Demolition Chane of Use <br /> DESCRIPTION OF WORK(addibonar splice provided an the <br /> `badj: <br /> (5j <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Typo of"act: _Now Addn Aiteration_Rapair Type of Prejeot ____New_Addn l(Atteration____-f2Apeir <br /> Show Number of Ifxrures Show Number of firWms K t > > <br /> A/C–air handling units Toilet <br /> Forted air gystarns Bathtub <br /> Gas pfp[ng pip[ La7at–ory wash basin <br /> Water heater Shower <br /> Gas fireplace 1<4chan&ink&d" oral <br /> Gag raniqla Dishwasher <br /> Clothes dryer Clothes washer <br /> Range flood Water heater <br /> Exhaust fan Sink eervice/bar/m eta <br /> Heat pump i Backflow preventer <br /> Unit heater Urinal <br /> 3 Bailer <br /> Drinking Fountain <br /> Refi eration J Floor drsin <br /> Woodstove Gnome trap <br /> ___Ducting__ Roof drains <br /> Other E Medical Gas <br /> SPRINKLER/SUPPRESSION SYSTEM Ocher <br /> Number of Heads Othsr <br /> 1 hwvby catfy that t have road and examined this appa=Uon and know the same to be true and rmrrecL ABprovwong of Iowa and prLlmnveo governing tris type of work will be compo <br /> YjM whathor spoeified harem or not Trw granting of a perms doge not presunro to give authority to violate or cane)the prDWalon of any oiherstate orto®t law ragrtlet&tg construmnn <br /> prat t a ofiivW by the owner of this property o pCrfortn tttC work W which epp$cAWn is made and i comply with the Gula Contractors taw 18.27 RCW and 296.200A WAC, <br /> 1 <br /> /( S <br /> OwnedAathorl:ad Agent SljnaWre Data �C 1, (R®viyg�t 8 014} <br />