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PERMIT APPLICATION <br /> BUILDINGIMECHANICAL/PLUMBING/SIGN/SPRINKLER/DEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 Cedar SL, Everett, V'JA 98201 425-257-8810 FAX 425-257-8857 www.everetfma.org <br /> SITEADDRESS: PROPERTYTA%p PE IT# ' <br /> IiiS�/�E.fOtJ EYW,498� �osoo�3aa boo6az � <br /> LEGAL for new conslrvclron. ShoR PlaVsubdivision_ Lot No,__ (altach copy of 1on91egal description� <br /> OWNER �D/,�t�T 6(�' u/�{l Pno�e�e-maii +/25-33�I-2Dgs <br /> �aa�ess 2l�5�l�IOC� $T EV/✓� !�8`za3 cny�sia�eiz�P ,EYE2EJr ,4- 9��3 <br /> APPLICANT:�Owner OwnefsAgenl Contracror _Conlraclor'sAgenl _ienan��m.:ip�caaea:eceroiw�,e.�ii�o�,ae�+�e�moowo.M��.ma.pa�a� <br /> CONTRACTOR /20�E2T /'✓� �'U� Stale Lia# City Bus. Lic.# <br /> � PhonelEmailY�.33�J' 2OFl.� (jp��r��@ <br /> Atldress' q�l�- T �� <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT ! <br /> P�one(E�mail Y�.f 3.�¢ 2��� �lf��CYlY/�d��'7 <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK <br /> ExiSting Use of Builtling �S/�'�QE � 's�� HEAT SOURCE�. <br /> Proposed Use of Building ^7'�'Q _ Gas_ Eleclric� o�her <br /> 8wlding type�. �i Sirgle Family�L�up�ex_7o�vnhcuse _ _h4ul!i-Family _Cemmercial <br /> Type of pro�ect. _ New f_Add�tion _Remodel __Repa�r ._T.I _._.Sign_Sprinkler_Oemohtion,_Change o(Use <br /> DESCRIPTIONOFWORK(add�trona�spaceew��vedeii;h�backt. ���?�� <br /> ,odd ..Sc,F�.U6 F�C1JR ��Wo �E'd�J.w — Gulc <br /> MEGHANICAL PERMIT APPLICATION PLUMBING .'ERMIT APPLICATION <br /> Typa of Pmject: _New_Addn _Aiteretion_Repair Typo of Project _New_Addn _Alteralion_Repair <br /> Show Number(p)ol Iixfures Show Number(N)o/lixfurcs <br /> A/C—air handling units 1. I Toilet <br /> � Forced air systems � BatMub <br /> � Gas piping � .1 I Lavatory(wash basin) <br /> Water heater ouE— � Shower _ <br /> � Gas fire lace � Kitchen sink 8 disposal <br /> � Gas range I Dishwasher <br /> � Clothes dryer � Cbthes washer <br /> ! Rangehood Waterheater _ <br /> � Ezhaust fan Sink(servicelbadmop/etc) <br /> � � Heat pump � BackOow preventer <br /> � Unit heater j Urinal <br /> 8oiler �rinking Pountain <br /> � Refrigeralion � Floor drein <br /> Woodstove � Grease trap __ <br /> Ducting � Roof drains <br /> I Other Medical Gas <br /> SPRINKLER I SUPPRESSION SYSTEM � other <br /> Number oi Heads � Other <br /> I n.reEy certily�.hal I have read antl esamined t�is applicafion an0 Mnowt�e same lo De�me and correc� All pmvisions oltaws ar.d ortlinanres goveming t�is type oi worM wll be complieE \ <br /> wi!�whel�er specifetl nerem or not.T�e grenlinq ol a pertnil C�es nol presume to give aulhonly lo viclale or cance�tha pmuixion ef any N,�er sla�^or local law regulaD.ig mnslrv�llon � <br /> Tnat I am aulnorized Ey�ne owner ol;ais pmpetly lo pertorm:�a work lar wnkh applicallon Is maaa and I comply wii�I�e Stale Conimcmrs taw 18.27 RCW an0196 2004�NP� / <br /> ���� r . � 8-/-/t( <br />