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� <br />� <br />PERMIT APPLICATION <br />BUILDING/MECHANICAL/PLUMBING/SIGN/SPRINKLER/DEMOLITI�N <br />CITY UF EVERETT PERMIT SERVICES <br />3200 Cedar St., Everett, WA 98201 425-257-8810 FAX 425-257-8857 www.everettwa.org <br />�).�.ivDDf IE11���1L's$����i��l� C��'Lf�i Vltrt ��,�J IP���� �1 �i � � � i� ��� I�IU ��i�#� '�2� <br />LEGAL for new consVuction', Short PlaUsubdivision Lot No _(attach copy of long legal description) <br />OWNER Zj„ `rv�(,'1,nC �.�. Phone/Gmail �1(� ' —�O" <br />Address ����, ��„�� City/StatelZip �,vL,j'�7't � C C,� <br />APPLICANT: _ Owner _ O�vner's Agent � Contractor _ ConVactor's Agent _ Tenant (m�si P�o��de a ieuer o� consem trom ine a,�,er i� ao �•.��k �� u,� sP,'e� <br />CONTRACTOR (,( (, („�i M1 A '1(; `� (,,� State Lic. # �(� ,J � 1 � City Bus. Lic. # r�53� <br />��2c�`i h�j1� Piact � , F-S �' � Phone/E �L; — !�% ^ t���� ,nn <br />Address ��y� �.�� r�9�o�� �- .t1 �., C . �il�,L . �pn l <br />TENANT BU5INESS NAME CON7ACT FOR PERMIT <br />Ph� eE-ma�li•��{=�3`r��y k - �,►`J1V .tC - `i\'m <br />BUILDING PERMIT APpLICATION CONTRACT PRICE OF WORK � ICi �(.� �`'� <br />Existinc� Use oF Building HEAT SO <br />Proposed Use of Building Gas Etectri <br />Building type: � Single Famiiy y Duplex,___Townhouse _„� Multi-Family � Commercial <br />7yNn �f N.n�oct• NeW Addition Reriodel Repair T.I. Sipn 5prinkler Demolition_ <br />DESCRIPTI(�N OF WOC2K (additiona� spaca provided on the b�ck) : <br />��,lt,:-�`��SS �1�'a� ��ua'�l�} <br />MECHANICAL PERMIT APPLICATION <br />pe of Project: _New _Addn �Alteration _Repair <br />Show Number jl!) of lixtures <br />I A/C — air handling units <br />i Forced air systems <br />i Gas piping <br />� Water heater <br />j Gas fire lace <br />Gas range <br />� Clothes dryer <br />; Ranqe hood <br />Exhaust fan <br />Use <br />PLUMBING PERMIT APPLICATION <br />pe of Project: _New _Addn _Alteration _Repair <br />Show Number (ft) of fixtures <br />' Toilet <br />� Bathtub <br />Lavatory (wash basin) <br />� Shower <br />I Kitchen sink & disposal <br />� Dishwasher <br />—� Clothes washer <br />! Water heater <br />! I-leat um Backfiow reventer inside bld <br />Unit heater i Urinal <br />' Boiler Dnnkin Foun[ain <br />Refri eration Floor drain <br />Woddstave Grease tra <br />i Ductin Roof drains <br />Other Medical Gas <br />SPRINKLER ( SUPPRESSION SYSTEM Other: <br />� Number of Heads Other: <br />I hereby certify fhaf I hnve read and examine.d this application antl know ihe same to be true and cerrect. Ni provisions of laws and orAinances governing this lype of work vnll be comp <br />wilh vAielher specifed herein or nal. The pranlinc� o( a permd tlacs not presume to c�ive aulhoriry Io viol�te or cancel Ihe provision o( any olher state or local lalv repul:�tinq construction <br />Tha _,a:rLaulhOnzed by the o�v n operty to perform the work for a:hich npplic�lion �s made and I comply wilh tho Sta:e Conlractors Law 18.?7 RCW enA 29Ci200�� WAC. <br />� � . . . . ` � . '(�,.�_...�.�...- � I � <br />���rir?7�?!ffinrN7+•:I h�ihflt 8!gn,xiyi�Ye t�9f�? ;�^r` H' 9':"'f''i <br />