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PERMIT APPLICATION <br />BUILDING/MECHANICAL/PLUMBING/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./o�rg <br />RE ACCEPTED FROM 8 AM TO 4 PM <br />APPLICATIONS A <br />SITE ADDRESS: Evr_PE7rr W.4 PROPERTY TAX# MIT If _O <br />11 grim <br />y02. SE EYERETr ii i SUITE SIO JTd <br />LEGAL for new construction: Short Plat/subdivision Lot No.. (attach copy of long legal description) <br />OWNER 3ited4,f Ewe&44 li LL- G Phone/E-mail Ja.,rs Pat o(w qy1 - L 23 - ;'7 O q <br />Address I9100 Vew Kae P+ $u:4[ 500 City/State/Zip T-rveNc CA 117-412- <br />APPLICANT:_Owner _Owner's Agent Contractor's Agent � Tenant lmosl praneealener of consenllmmine :vmar to aoworx o ma space) <br />cContractor <br />"jew Co nilCoL & I Lic. it COE Bus. Lic. # <br />CONTRACTOR ct <br />Phone/Email <br />Address <br />TENANT BUSINESS NAME <br />CONTACT FOR PERMIT <br />,J;k; ISror.� or Hark Kept, <br />U L T A B r A u T Y <br />Phone/E-mail 5 10 - RIG S- S L G 5 <br />BUILDING PERMIT APPLICATION <br />CONTRACT PRICE OF WORK S 4 00 0 0 O . 0 0 <br />Existing Use of Building N E k GA N T I L F HEAT SOURCE: <br />Proposed Use of Building A G IR C 4 N T 16 r Gas Electric_ Other_ <br />Building type: Single Family _ Duplex _Townhouse _ Multi -Family X Commercial <br />_ <br />Type of project: _New Addition __ Remodel Repair X T.I. Sign _Sprinkler Demolition_Change of Use <br />DESCRIPTION OF WORK (additional spaceprowdedon the back): <br />WOrlt-cl.-e�tt <br />L of <br />11 erto.+t'i (e +e,a+-F ;. reovtrf,t PrOjetit, Tf+G SLe' I / <br />rail e5l MC�L �.4 r�p(r3L �'X i'snfinq r <br />.Jl <br />I� rLfli[0./ <br />,'KSW(4i'ON Ot iNf GrrO✓ p011'l il'eN Cr GI 1 M,* <br />and fr..�sl. ,.P9radcf,1 <br />MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br />Typo of Pro)c l: <br />_Addn :LAllerallon _Repair <br />pa of Project: _New _Addn Alteration _Repair <br />_New <br />Show <br />Number (#) of fixtures <br />Show Number (#) of fixtures <br />A/C - airhandlingunits <br />i I Toilet <br />Forced air systems <br />I Bathtub <br />Lavatory (wash basin) <br />Gas piping <br />Shower <br />I <br />Water heater <br />I Kitchen sink & disposal <br />Gas ---place <br />Dishwasher <br />s ran a <br />I Clothes washer <br />I <br />Clo es dryer <br />I <br />Water heater <br />Ran ood <br />I Sink (service/bar/mop/etc.) <br />y <br />Exhaust n <br />BackFlow preventer <br />Heat pump <br />rival <br />Unit heater <br />1 D' kin Fountain <br />Boiler <br />I Floo rain <br />Refri oration <br />Greas rap <br />Woodslove <br />I Roof drai <br />y <br />I Ductin <br />Medical Ga <br />11 Other <br />SPRINKLER <br />/ SUPPRESSIONS STEM <br />Other: _ <br />Number of Heads <br />I Other: _ <br />I hereby cendy that I have mad and examined this application and know the same to be true and correct. All provisions of laws and ordinances governing lh'is type otwork will be i:ompl ed <br />with whether specified herein or not. The granting of a permit does not presume to give authority to violate or cancel the prevision or any other stale or beat Law regulating construction <br />296.200A WAC. <br />That 1 am authorized by the owner or Ibis property to perform the work for which applioalmn Is made and I comply with the Slate Contractors Law 18.27 RCW and <br />Ownar/Authorized Agent Signature Date <br />'(L <br />(Revised 612012) <br />