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PERMIT APPLICATION <br /> BUILDING/MECHANICAL/PLUMBING/SIGN/SPRINKLER/�7EMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 Cedar St., Everett, WA 98201 425-257-8810 FAX 425-257-8857 �•,na�v.everetriva.or <br /> �7-a <br /> SITE A�JGRESS: ` PROPERTY TAX d PERMIT Y <br /> SJ'� �S � oJ A " ��� <br /> LEGAL for new conslruclien: ShoA aVsubdivision Lol No._ (allach topy of long legal description) <br /> OWNER �d � PhonelE•maii� u'L5 29G - S SIS <br /> Address �j� L� v lONwo. Gity/State/Z�p <br /> APPUCANT: Owner _OwnefsAgent ConlraUor�COMrzC10r5Agen1 _TC�BO�(musiD�aeeietteroiwnscathomtAaw.namaowcMmmospaw) <br /> CONTRACTOR � I .,,. � . ,�v� Z n� State Lic.tt CCK -RC I S R� CAy Bus. Lie # O 1 Z <br /> naa«ss ��S(� 09�` Ct N 4� 5����� ln�f� qbL71 PhoneiEmail y2 3 � GoZ2 <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT <br /> Phone/[-mail 4�z S 3 3��� 6� 2 2 <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK � � � . 6� (� GOD <br /> ExislingUseoff3uilding y�PS� '�-�. �_ HEATSOURCE�. <br /> Pnposed Use ol Building S o.n�C Gas__ Elecinc Other_ <br /> I3wlding lype� �Single famdy _buplex_Townhouse _Multi-Family _Commercial <br /> Type ot proJecl: New Adddion )C_Remode� _Repair_T.I.___,Sign_Sprinkler_Demolition_Change of Usc <br /> DESCRIPTION OF/�WORK�adnd�lrona�space plovrded on t—heI-ba�c1k�•: 1 <br /> F�eQ �.tc h°Gf �.e�e� 1L� � f Ili^n6 •^� , �1Cw W�n��V 5 �n �..�ti-�-,� <br /> ��CN,.`5 <br /> J � <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Typa o1 ProJocl: `�` New_Addn Alleration�Rupalr Typo ol PreJoct: _Now_Addn �Altoration_Ropair <br /> Show Number(al ol lixtums Show Num6er(N)ol(rtures <br /> NC -air handling unils Toilet <br /> I I-orced ar s stems Oathtub <br /> Gas piping I.avalo {wash basm) <br /> � Waler heater Shower <br /> Gas fireplace 1 Kilchen sink&disposal <br /> Gas range / Dishv+asher <br /> I Clolhes dryer � � I��_ Glolhes washer <br /> Range hooA T� Watcn c�ater <br /> Exhaust lan Sink(service/badmop/etc) <br /> Hcal pump I l3ackllow prevenler <br /> Unit lieater Unnal <br /> I Boilcr Drinking Founlain <br /> Reingeratwn �loor drain <br /> � Woodstovc Grea,c Ira � <br /> Duchnq - „ I,,,,, . Roof drains <br /> � Olher Medical Gas <br /> SPRINKLER / SUPPRESSION SYSTEM � O�her <br /> Number o(Heads I Other: <br /> I hcreby ccrtAy I�al I have wad and Caamined Ihia appiiwLon anU know Ihe samc Io bc Ime and wrrCcl All Dtovislons W 10w5 and orEmanv:s goveming IArt rype or worv w�u ec�ompn�n <br /> wdh whrlher spedficd Acrein a not Pm grenling ol a pr,rtnA docs nol Dresumo lo give a�ltior�ty tu violale or wnccl Ihe piovision ol any o!�Cr slale oi local I.iw requialin7 Conslmn•on <br /> ih;d I am aW�onzM by ID^owncr ol Ihis propriry to ycAoim I�e woA.tO�whirh npplication is niaon nn71 co:nply.Mh Ihc.',lalr f,onlratlo�e Law IB 77 RCW an015G 7IX`A W/C <br /> -��c�A� �/3� <br /> OwnorlAuthoriz f ont Signalum �— Data previcen 3�'ot3) <br />