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PERMIT APPLICATION <br />BUILDING/MECHANICALIPLUMBING/SIGN/SPRINKLER/DEMOLITION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 Cedar St., Everett, WA 98201 425-257-8810 FAX 425.257-8857 www.everettwa.org <br />SITE ADDRESS:._ r <br />24fi 1C4j EOTNurr S-r <br />PROPE TY TAX p <br />G�4{n-73 - 005 - CO? <br />PERMIT # <br />01505--053 <br />LEGAL for new construction. Short Plattsubilvisrog fl f6HA ¢i jsr __t of No ]_'8 (attach ccpy or long legal aesa�pl 0,I) <br />OWNER GWfr U(c #AtW Lf-G <br />Phone/E.mad <br />Address P 0. FjOX S-Z L <br />City/State/Zip I ANY r W Pr qb6L>q - 5 2 2 Z <br />APPLICANT:X Oww, __Cwrers;-cent Contractor Contractors Agent _Tenant (Rcsip-I III,, r.�r .r ii r. m•o.-.-'a du.c�r.i.e qa: <br />CONTRACTOR OWIJUW7 <br />State Lie 0 Cny Bus LC # <br />Address I Phone/Email <br />CONTACT FOR PERMIT ' <br />_ <br />lPhovell' marl ?�O -701 8� <br />BUILDING PERMIT APPLICATION <br />CONTRACT PRICE OF WORK _. <br />Exisli^ig Use of Building G Pro-pK-i F-HEAT SOURCE _ <br />Proposed Use of Building G�fall E, Ga. F'ecbic -,Other <br />Builtling type V Single Family _ Duplex _Townhouse _ Multi -Family _ Commercial <br />Type or project New ✓ Addition Remodel Repair T t Sign _Sprinkler Demolition Change of Use <br />DESCRIPTION OF WORK (add honer space provided on the back) - <br />�1t.W <br />MECHANICAL PERMIT APPLICATION <br />PLUMBING PERMIT APPLICATION <br />Type of Pro)ect New _Addn __Altiiralion _Repair <br />Show Numberf#) offixtures <br />Type of Project. _New _Addn ._Alteration __Repair <br />Show Number(a) of fixtures <br />A/C - ad handling units <br />Toilet _ <br />Forced air systems <br />Bathtub <br />_ <br />Gas piping <br />Lavatory (wash basin) <br />Water healer <br />Shower <br />_ _ <br />Gas fireplace <br />Kitchen sink i1 disposal <br />Gat range <br />Dishwasher <br />_ <br />Clothes dryer <br />Clothes washer <br />_ <br />Range hood <br />Water heater _ <br />Exhaust fan <br />Sink service/bar/mo Ia10. <br />_ <br />Heal pump_ <br />Backllow preventer (inside bld <br />Unit heater <br />Urinal _ <br />Boiler <br />Drinking Founlain <br />Reln eration <br />Floor drain <br />Woodslove <br />Grease <br />_ _ <br />Ducting <br />Rool drams <br />_ <br />Other <br />Medical Gas <br />SPRINKLER <br />I SUPPRESSION SYSTEM <br />Other. <br />T7777er of Heads <br />Other: <br />I hereby cendy that I have read and evamiaed this applcatron and knoe the same to be If and Correct All provWons of laws and ordinances governing This type at work will be complied <br />with whether apeclfied herein of not The granting or a permit does rat presume to gwe aulnonly to violate a cancel the provision at any other slate or local law regulating consiruCton <br />Thal I am sulhowed by the owner at Inns Properly to pvdorm Ine work for which applocalan is made and I comply with the Slate ContraClors Law is 27 RCW and 296 200A WAC <br />S/fQ/l7 <br />Owner ut wnred gent ignitors Date (Revised 4?Of5) <br />t <br />