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• <br />PERMIT APPLICATION <br />BUILDING/MECHANICAL/PLUMBING/SIGN/SPRINKLERIDEMOLITION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 Cedar St., Everett, WA 98201 - 425-257-8810 — FAX 425.257.8857 — mmeverettwa.org <br />-- nwcrrcu <br />SITE ADDRESS: <br />rrcvm CArrl T04PA1 <br />n -� e_ <br />L ( <br />��Fn11, O p <br />Q <br />0 <br />LEGAL for rexeonstr=cn: Shoff Plat/subdrvislon Lot No (ttach copy long legal <br />__ of descripCon) <br />��!! ���� <br />OWNER L.O CnS t (2.. PhonerE•mall 0;1J�/Q—/FOJ <br />Address C6 lCity/State0l) <br />CONTRACTORNTr L 8 1 Llc. NAP <br />Address G{rr 9 PhonerEmail <br />TENANT BUSINESS NAME CONTACT FOR PERP.IIT <br />cL �ELIC( s g/W 2a064(-F <br />BUILDING PERMIT APPLICATION <br />CONTRACTFIR ICEOFWORK gt XJ_ r%x <br />Existing Use of Building Re-StaU Y-d 1 � <br />HEA7 SOURCE <br />Proposed Use of Building <br />Gas Electric Other _ <br />iBuilding type: _Single Family _ Duplex ,_Townhouse _Multi -Family <br />-XCommercial <br />Type Of project: `New _Addition _Remodel _ Repair _T.I._ Sign _Sprinkler _Demolilion_Chenge of Use <br />Description of Work (additional apace provided on the back): �N�. AZ[� A14W �j r/' 779APr <br />Have you started working Without a permit? _YES _NO <br />MECHANICAL PERMIT APPLICATION <br />PLUMBING PERMIT APPLICATION I <br />Type of Frojcct. _New_Atldn _Alteration _Repair <br />Type of Project: _New_Addn _Alteration <br />Show Number ClofNxtures <br />_Repair <br />ShowNumberp)ori7xi res <br />AIC-alr hantlling units <br />_ _ <br />Tolled - <br />For edairs stems <br />I Bathtub <br />OaI in <br />Watt er heater <br />wash basin <br />Shower <br />Gas Ore taco <br />FOtehen sink & disposal-- — <br />--� <br />Oae range <br />I Dishwasher ' <br />Clothes dryer <br />Clothes washer <br />Ran a hood <br />Water heater - <br />Sink servicelbarrmo etc. <br />eatp p H <br />Heat um <br />Becknow reventer <br />Unit heater <br />Urinal <br />Boiler <br />Odnkin Fountain <br />Refrt eratlon <br />Floor drain <br />Wtwdstova <br />Grease trap <br />I <br />Root drains <br />Othe <br />Other <br />Medical Gas <br />SPRINKLER / SUPPRESSION SYSTEM <br />Omer. <br />Number of Heads <br />Omer. <br />I hereby certify that I have read end examined this application and know the same to be We and correct All provisions of laws and ordinances governing <br />this type of work will be complied with whether specified herein or not The granting of a penult does not presume to give authority to violate or cancel <br />the provision of any other state or kcal law regulating construction Or the performance of construction. That I am authorized by the Omer of this property <br />is to perfo a work for which a plicatk arts and 1 tampty vAm me St to Contractors Law 18.27 RCW aM 296.200 WAC <br />�� 9�3/3 <br />Owneoforized AgenlVIt§nothre/ Oath_ (Revised Z2011) <br />