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W)W,# 0ra330/ <br />/ PERMIT APPLICATION <br />BUILDING/MECHANICAUPLUMBING/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 erg <br />APPI IV ATIONS ARE ACCEPTED FROM !t AM TO 4 PM <br />RESS: /D O� / z <br />PROPERTY TAIL o / oo <br />O_ <br />PF <br />near construction Short Plat/subalvbOn Lot No (gnaw copy of long legal aexnQrwon) <br />V <br />/O 1.0 <br />clrv/StateJLp Oe.LJ <br />APPLICANT:_ Owner _Ownds Agent Contractor _Contractor's Agent _Tenant(mvu dowse aksa of mvsem eom oe e.memee.e+.me 1W?I <br />CONTRACTOR <br />L 8 I Lic d ,_. Q -Y JU5 COE Bus LIc 111053301 <br />aaeu 9.)3/pnoneJErld <br />TENANT BUSINESS NAME <br />NTA TEAR PERMI <br />phone/ mail) <br />BUILDING PERMIT APPLICATION 1CONTRACT <br />PRICE OF WORK _ <br />Existing Use of Building <br />HEAT SOURCE <br />Proposed Use of Building Gas _ Elednc Otner <br />suilding type. YSrngle Family _ Duplex _Townhouse _Multi -Family _ Commerdal <br />Type of orto ect New Adddlon Remodel Repau T I S n Sprinkler Demoldlon Chan a of Use <br />DESCRIPTION OF WORK (additional space pmyWedd onnthe back).fiAA <br />MECHANICAL PERMIT APPLICATION <br />PLUMBING PERMIT APPLICATION <br />Type of Project. _Haw YAddn _Afferation _Repair <br />Snow NulnbM of firtures <br />Type of Project: _ New _Adrtn _Alteration _Repair <br />Snow Number (s) of hrtures <br />A/C - air handling units <br />Toilet <br />Foroed air systems <br />Bathtub <br />Gas pipin <br />Lavatory (wash basin) <br />Water heater <br />Shower <br />Gas fire lace <br />Kitchen sink d disposal <br />Gas range <br />Dishwasher <br />Clothes dryer <br />Clotheswasher <br />Range hood <br />Water heater <br />Exhaust fan <br />Sink (servioe/bar/m /etc ) <br />Heat pump <br />Bacldtow preventer <br />Unit heater <br />Unn a1 <br />—__..—_—__—.. <br />—.--- _—. —_ <br />Boller <br />Dnnkln F_— <br />ountain <br />Refit erabon <br />Flocr drain <br />Woodstove <br />Grease trap <br />Ducing <br />Roof drains <br />Other <br />Mec Ical Gas <br />SPRINKLER / SUPPRESSION SYSTEM <br />Other <br />Number of Heads <br />Omer <br />I hereby caRay mat I have read and euirmed tin appleu," and """ same to be bee and coned. M provisions of taws and crenances governing Mrs lype or wore vall be complied <br />wlm wnemer sperfiMheren error Thogranbngofa aM,, not pee so me to give acmoldy to wolate se cancel Me Meyerson of any oeler slate or laal bw regWabng eonsbedloe <br />Thal I m iuMe bin mo er b m,5 propeM m crtorm the wak for.sfimll apptraboo,s malsdemand I cornpty min me Slate CMrradork Law to 22 RC W and 2% 200A 1YAC <br />Owner/AlAhorized Agent Signature Date (Revised 5.012) <br />