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PERMIT APPLICATION <br /> BUILDIN ME.0 AANIC A PLUMBING/SIGN/SPRINKLER/DEMOLITION <br /> CITY OF EVERETf PERMIT SERVICES <br /> 3200 Cedar St., Everett, WA 98201 425-257-8810 FAX 425-257-8857 www.everattwa.org <br /> arm AO ��.t�'1 �` �r_ �OPER7Y #�1113� �E ��� PeRMIT�F — <br /> LEGAL for new cartstrucdron: shaft 1NaUarrbrJfvision _ Vzt:No_. (atteon copy of I"Iega1 asscfipbon) <br /> OWNER it plwne/i mail 30i� <br /> rtes p (C)1'1 4 Y1 j � ve- -r1 'vV q z'-O <br /> APPUC/W T:_Omer —dwneez Ager;1 �Contrador _Contractor's Agent ,Tenant prmu Fumy a W"ar ar cwaam rmm me am"m m worn m me wem) <br /> CONTRACTOi ud�v /��� jsr�t� . D 53 <br /> Brass 00 �chak II L/r �1 �1116vu� 0a 0 PhorefEmol Cep �P—fy W�atl <br /> BUSINESS NAME CONTA:7 FOR P J09T <br /> 1%,C" P_"," <br /> PhormVE-mait 9' <br /> BUILDING PERMIT APPLICATION. CONTRACT PRICE OF WORT( <br /> Fodstfng Use of Building HF-AT SOURCE- <br /> Proposed Use of Suildim Gas Electric Omer <br /> W[ding type: _Single Family _DopleX Townhouse Muhl-Family _Commercial <br /> Type of prowt New Addition Remodel Repair T.I. §Ign__.Sprinkler Dernobon Change of Use <br /> DESCRIPTION OF WORK(additions!space provided on the baM: W/, 1a Q f l <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION .. <br /> Type of Project! _Naw_�Addn __Attorilion_Repair Type of Pr4-t NawNtldn Nttarattan_Rapalr <br /> Show Number JW of fixtures `'l Show Number 02 of f()tumv <br /> f A/C—air handling units I Toilet <br /> Ford air stems ; Bathtub <br /> Gas i uvaf wash basin <br /> Waterheater i Shower <br /> 1 Gas fireplace "chert sink&disposal <br /> Cas ranga Dishwasher <br /> Clathas dryer Clothes washer <br /> Rang&hood i Water pester <br /> 11chaust tan Bink esrvieelbar/m etc <br /> i Heat RUMP Backflow preventer <br /> Unit heater Urinal <br /> Baiter E Drinking Fountain <br /> Re ' arativn Floor drain <br /> Woodstove t Grease tra <br /> 3 <br /> Qucfing Roof drains <br /> Other Medical Gas <br /> SPRINKLER t SUPPRESSION SYSTEM Other. <br /> Number of Heads i Other. <br /> I hereby cerfgy that 1 have read end a-mimad this appguetkn and lataw the same to!re true and carreCL AH pmvi dorts of&avis aid ordbyux:aa govampig psis Wa of wart w9 be comp) <br /> wM w41eth8r spOWAd hmOn ur not Tha gwitatg or a panrdt does nal proal ma to gir9 ardhntdy to vlalma or�rrret tha pmvttrion of any other state or b Ed taW MgrdrrSng cM>S=ZE±ton <br /> That 1 am ga8romad by the owner of this Wopwty to pfdorm thavooA forwhidr appkawn is made and 1 cuu4*wRh the State Contractors Law 18.27 RCW and M,-( A WAC. <br /> / A <br /> bmintbAutfiohiod Agom Signature (Revlsed 912014) <br />