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PERMIT AP ' !CATION <br /> BUILDING/MECHANICA PLUMBING/. IGN/SPRINKLER/DEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 Cedar St., Everett, WA 98201 425-257-8810 FAX 425-257-8857 MON.everettwa.org <br /> SITE ADDRESS: PR PERTY TAX# PERMIT* <br /> 2710 Oth St _ J.�'-7 717Oo4-00 I00 4A (coo 3-031 • <br /> LEGAL for new conEuuctlon: Short Plat/subdivision - _ Lot No. (attach copy of long legal <br /> description) <br /> OWNER R b CSS y r— Phone/E-mail ZO p 5 (� �7 l <br /> Address ri q o i 13th .`-)"t City/6tat i p E v -e4-1- q g Lot <br /> APPLICANT:_Owner _Owner'o Agent ContrrCtvr Caritrectcr a Agent _Tenant(must provide a tetter of mneant from the ownerto do wart in the apace) <br /> CONTRACTOR GUQ d?rn W7')l ,V {-?eakiSiState Lic,# 1i it57-1 -qv()ppCity Bus. Lic-# 0 534yq <br /> ` i /, , � SJ A bete gri0O5 - �-q7f- ' AticTewi <br /> Addr+ass (�QV [(.rl�/ ' 1 PhonafErnQii WQ <br /> : 11,111;E <br /> R <br /> . Phone/E-mailC 00— / " j <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK, 0a <br /> Existing Use of Building 1\�'_{�QyIGC HEAT SOURCE: <br /> Proposed Use of Building_ t3aa Eiedi-ie Other <br /> Building type: �_.Single Family Duplex Townhouse - Multi-Family Commercial <br /> Type of project New Addition Remodel Repair_T.I. Sign, Sprinkler Demolition Change of Use <br /> DESCRIPTION OF WORK(additional Space provided on the back): <br /> 11/10 a ( e-e/Pla_a e /—eC WbLer— Afai67. <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type of Project _New__1ddn JAtterstIcet impair Type of Project: New tddn Attnration Repair <br /> Show Number(19 of tfxfuree Show Number(#)of fixtures Rep (. Le <br /> NC—air handling units 1 Toilet <br /> Forced air systems - f Bathtub <br /> Gas piping 1 Lavatory(wash basin) <br /> Water heater {L Shower <br /> Gas fireplace ; Kitchen sink&disposal <br /> Gas range 4 Dishwasher <br /> Clothes dryer ; Clothes washer <br /> i Rands <br /> hood J <br /> _----- - � Water heater <br /> Exhaust fan • _Sink(rvioe/bar/mop/ete) <br /> Heat pump _ _ _ Backf ow preventer <br /> Unit heater ! Urinal <br /> Boiler _ Drinking Fountain <br /> Refrigeration Floor drain <br /> Woodstove} Greas a trap <br /> Ductin <br /> 9 of drains <br /> Other Roof <br /> Gas <br /> SPRINKE.ER./SUPPRESSION BY9,E Other: <br /> } Number of Heads Other <br /> hereby certify that I have read and examined fila app1cafien and know the same to be true end correct An provis on6 of Iawc and ordinances governing this type of work will be camp <br /> with whether-sped/lad Wain or not The granting of a permd does not prasuma to g ve authority to vtofate or cancel the pmvieion of any otnet State or beat law regulating tOnsuuCtion <br /> That I ani Orized by the ownop <br /> :or of this property to perform the work fOrwhlch application Es made and I comply with the State Contractors Law 9827 RCW grid zurszoOA WAG, <br /> A 3/( /1t <br /> OwnerlAuthorized Agent Igneture bate (Revised 9/1074) <br />