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PERMIT APPLICATION <br />BUILDING/MECHANICAL/PLUMBING/SIGN/SPRINKLER/DEMOLITION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 Cedar St , Everett, WA 98201 - 425-257-8810 - FAX 425.257-985 t - vrArw everettwa ofg <br />APPLICATIONS ARE ACCEPTED FROM a AM TO 4 PM <br />SITE ADDRESS: <br />PROPERTY TAX e <br />MIrT-� <br />N✓r a•t 60 r� <br />LEGAL Id new mnsttuctmn Shorf PlaVwod�wswn S•✓,Zir*y£<c.r J�r1 Lot No MLIZ. (attach copy of long legal desniphon) <br />OWNER 61FIAI <br />Pnonele-matl yJ—_ <br />ntlmess <br />Ufy'Slale?tp Q '7 / <br />CONTRACTOR i•• . / <br />L S I Lic a <br />Asvrss > V— - 1/•' ��r'.10 PhonNEmul <br />TENANT BUSINESS NAME <br />CONTACT FOR FERMI <br />Phone/Email <br />BUILDING PERMIT APPLICATION <br />CONTRACT PRICE OF WORK <br />Existing Use of Buddmg In/.b� '%E�2ia HEAT SOURCE <br />Proposed Use of Building Gas Elecinc Omer <br />Budding type _ Single Family _ Duplex _Townhouse _ Multi -Family _ Commercial <br />Type of project. _r New _ Addition _ Remodel _ Repair _ T.I _ Sign _Sprinkler _Demolihon_Change of Use <br />Description of Work (addeninat space provided on the back) y0 � X o7.5 ' V 4 . wo) <br />Have you started working without a permit? _YES ✓NO <br />MECHANICAL PERMIT APPLICATION <br />PLUMBING PERMIT APPLICATION <br />Type of Protect_New __ Addn _Alteration __ Repav <br />Show Number Al of fixtures <br />Type of Projerl __ New _Addn _Altrrahnn Repair <br />Show Number (el of fixtures <br />A/C — air handling units <br />I Tottet <br />Forced airs stems <br />_ <br />I Bathtub <br />Gas piping <br />Lavatory (wash basin) <br />Water heater <br />Shower <br />Gas fireplace <br />Kitchen sink 6 dis osa <br />Gas ran a <br />Dishwasher <br />Clothes d er <br />Clotheswasher <br />I Range hood <br />Waler healer <br />I Exhaust fan <br />Sink (senticefbaffmop'eK i <br />Heat pump <br />Backflow preventer <br />Unit healer <br />Urinal <br />Boiler <br />I Drinking Foureain <br />Hefri etehon <br />F loot drain -- — ---_- - <br />Woodslovc <br />_ <br />I Grease Irain <br />Ducting <br />Rooldtams <br />Other <br />Medical Gas <br />SPRINKLER / SUPPRESSION SYSTEM <br />I <br />Other <br />Number of Heads <br />I <br />Other <br />I hereby certify real I have read end as Anti mad this application and know the tame to be true and WIWI All provisons of laws and ordinances governing <br />Ihts type of work will be compked wth whether speolf,ed herein or not The granting of a permit does not presume to give authority to woae or cancel <br />the provision of any other stale or local law regulaluig construction or the performance of consInactilin That I am Authorized by the meet of IAA properly <br />to perform the wo wit ep on t 9ede and I comply with the Stale Contraclors Law I a 27 RCW and 296 200 WAC <br />OwnerTAutnonsed Agent Sign pale (Revised 2/20t 1) <br />��v <br />