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i <br /> 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.eve�ore�.org <br /> SITEADDRESS: PROPERTYTA%k P T74r <br /> 2c:, c= uc�G��ri-r�1 r,�t.� � � <br /> LEGAL for new conslruction: Short PlaVsubdivision Lol Mo._ (atlach copy of long legal descriplion) <br /> OWNER �}F =/� � U � l� Phone/E-mail z-,$�0�9 ���g <br /> Adtlress CitylStalelZip <br /> APPUCANT: Owner OwnefsAgenl _Contractor Conlraclor'sAgenl _Tenant�musia�»eeaionero�wnsemaommeo«nermoowor�inmasPace) <br /> CONTRACTORLN/"RASO ` i-� �z17-v�S State Lic.#�NFRh SL�S�7� G Cily Dus. Lic.# <br /> Address � �-1 (� S(C W AZ� c PhanelEmail 42S-sG�•�'l3� <br /> TENANT BUSINESS NAME 2i � ` `� �ONTACT FOR PERMIT <br /> /�0 �U f-�- PhonelE-mail <br /> BUILDING PERMIT APpLICATION CONTRACT PRICE OF WORK��� On <br /> HEAT SOURCE: <br /> Existing Use n!Building <br /> Proposed Use of Building Gas�Electric_ o�her_ <br /> Buildng type: _Single Family __Duplex_Townhouse _Multi•Family .�Commercial <br /> Type of project. _New _Addition __Remodel _Repair_T.I._Sign_Sprinkler_Demolition_Change of Use <br /> DESCRIPTION OF WORK(aAditiona�space provided on the back): <br /> ,e�Lvc.a-i'Fo••/ ` CTr.�.s �t`Tr2 <br /> MECHANICAL FERMIT APPLICATIr N PLUMBING PERMIT APPLICATION <br /> Typo o(ProJoct: _Now_Addn _Alleralion_Repalr Typo of ProJecl: _Nuw_Addn _Altoration_Ropair <br /> Show Num6er(N)o!/ixtures Show Number/#)o(fixfures <br /> � A/C—airhandlingunits I Toilei <br /> � Fc;aed air systems � Balhlub <br /> Gas piping � Lavatory(wash basin) <br /> Water heater I Shower <br />` � Gas fiieplace � Kitchen sink&disposal <br /> � Gasrange � Dishwasher <br /> i Clothes dryer I Clothes washer <br /> � Range hood I Water healer <br /> � Exhausl(an � Sink(service/bar/mop/etcJ <br /> � Heat pump I BackFlow prevenler <br /> Unit healer I Urinal <br /> � Boiler I Drinking Fountain <br /> � Refrigeration .I Floor drain <br /> � Woodstove � Grease trap <br /> Ducting � Roof drains <br /> � Other � Medical Gas <br /> SPRINKLER / SUPPRESSION SYSTEM I Other: <br /> � Number of Heads � Other: <br /> I hereby cetlify Ihal I hnve reatl and examined this opplication nnd know the samo lo be Irue and cortect.All pmvislons oi laws and ordinances governin9lhis type ol work will be complied <br /> wit�whether specifieC herein or nol.Tlie granting ol a pertnil does nol presume to giva auNoriry to violale or wncel the pmvision ol any other stale o�local law regulating construqian <br /> Tha11 am authorized by the owner ol Inis pmpeny lo pedorm Ine work forw�lch application Is mada and I wmply wil�Na Steta Convactors Law 1827 RCW antl 246.200A Y:AC. <br /> �� ��c-' �� S'�/.3 <br /> OwnadAyNSorizod A9ont SlgnaWm <br /> Date (Revised 3R073) <br />