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• <br />• <br />PERMIT APPLICATION <br />BUILDINGIMECHANICAUPLUMBINGISIGNISPRINKLER/DEMOLITION <br />CITY OF E' E ETT PERMIT SERVICES <br />3200 Cedar St.; Everett, WA 98201 425-257-8810 FAX 425-257-8857 wmv.evefettwa.org <br />SITE ADDRESS* PROPERTY TADS # <br />.5 Jam. <br />PERMIT � <br />LEGAL for new constmclion: Short Platisubdivision= i Lot No., _ (attach ropy of long legal description) <br />OWNER i %:i 5-1 T -f—'t + i_ ', to <br />Phone"E-mail 20 4!G f r" a a r-rzf,a - <br />Address ?` C:1 i ';7' .' J a �. � � o <br />CityiStatw�r7ip K E' A,. '1��--Y=- .i,a'—., e:: �;i i C°�• <br />APPLICANT: —Owner _ Ownef s Agent _Contractor _ Gontraclor'S Agent 8i Tenant (must provide a letter or consent from the avier tc do sv". in sw sPZce) <br />CONTRACTOR 'BEW4109 F AJ C V f T i Ct-� <br />State Lic. # r � F4L4 A 6 )- , City Bus. Lic. # <br />�t t # <br />Address { _ d ", LAD Z'r �'7 `?�, P1 C, - '; E, L , z ��� �" €" <br />` •� xr ' ` � 5%> <br />PhonetE wait � E e..i_; ,.. t <br />TENANT BUSINESS NAME CAL3i�tiiTACT FOR PERPdi€T <br />F' 6- -j 6.6 {. -'..� E;J S' '°�3e= #'^- ,Y .M.•-�-y a.# _ r"fl.. 15, 41j cc, A-. i'1v <br />PhonetE-mail AAri -. of <br />BUILDING PERMIT APPLICATION CONTRACT PENCE OF WORK` <br />Existing Use of Building . 'ems c t % t: .__ HEAT SOURCE: <br />Proposed Use of Building s Gas Electric Other <br />Building type: _ Single Family _ Duplex Townhouse _ — Multi -Family _Commercial <br />Typie of project: New Addition Remodel _Repair T.1. Sin Sprinkler Demolition Change of Use <br />DESCRIPTION OF WORK (additional space provided on the back] : <br />--,r'7.A v 12. i" P`.k'+..s•.. L..; — .�."' "t t.. .i x-- ". ". -s�.` i .� j " .c. •' t'Ca- <br />1,J� <br />u 05 a, e'; `F 4, ta!+C+. r <br />MECHANICAL PERMIT APPLICATION <br />Type of Project: `Now-._Addn _A[torat"son Repair <br />Show Alumber (#) of fixtures <br />PLUMBING PERMIT APPLICATION <br />Type of Project; _New _Addn Alteration _, Repair <br />Show Number #t of futures <br />A IC — air handling units <br />i Toilet <br />Forced airs stems <br />Bathtub <br />Gas piping <br />Lavatory (wash basin <br />Water heater <br />Shower <br />Gas fire lace <br />Kitchen sink & disposal <br />Gas range <br />Dishwasher <br />Clothes dryer <br />l Clothes washer <br />Range hood <br />Water heater <br />Exhaust fan <br />Sink serviceibartmo fete. <br />Heat pump <br />Backfiow preventer <br />1 Unit heater <br />urinal <br />Bailer <br />DrinkinI Fountain <br />Refrigeration <br />Floor drain <br />Woodstove <br />i Grease trap <br />Ductin2 <br />Roof drains <br />Other r - 7` =%-' " P a I 1 A <br />( Medical Gas <br />SPRINKLER I SUPPRESSION SYSTEM <br />other: <br />Number of Heads <br />Other: <br />t hereby certify that i have read and examined this application and know the same to be true and corned. All provisions of faws and ordinances governing this type of work Vitt be comp <br />with whether specified herein or not. The granting of a permit does not presume to give authority to violate or cancel the provision of any other state or Isom law regulating construction <br />That I am authorizers by the owner of this property to perform the work for which application is made and I comply with the State Contractors Law 18.27 RCw and 296-200A VAC. <br />WLM-401 Y 7z� :1/9 <br />Owner/Authoriziffi Agen ignature Date (Revised 9/2-014) <br />