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PERMIT APPLICATION <br />BUILDING/MECHANICAL/PLUMBING/SIGN/SPRINKLER/DEMOLM ON <br />CITY OF EVERETT PERMIT SERVICES <br />3200 Cedar St., Everett, WA 98201 425-257-8810 FAX 425-257-8857 www.everettwa.org <br />APPLICATIONS ARF ACCFPTFO FROM 8 AM TO 4 PM // _; 3 —12 <br />SITE ADDRESS: <br />0 5 V rP� Ftiawrx SI <br />PROPERTY TAX If <br />MIT # <br />LEGAL for new construction: Short Lot No— (attach copy of long legal description) <br />OWNER Mjk <br />rPllaVssubdivision <br />W l.�/�—1 <br />I <br />Phone/E-mail 3 & Q — 9I q " <br />(1,./1-r0� <br />Address p0 gc0 ZZvnll7 I <br />City/Slate/Zip \)orci ,,,per 36 g <br />rnracoeni ham the to do.A in in,v sp-* <br />Contractor _Contractor's Agent —Tenant vtlo a kmowner <br />Owrier 4Oefs Aggepm <br />APPLICANT:_wn <br />1nt <br />1 <br />CONTRACTOR A ZC0 1 1 :yl r"1 , !1 <br />L & I Lic. # MO,n 2c 4 q 2-b 13SCOE Bus. Llc. # <br />Address Phone/Email <br />TENANT BUSINESS NAME <br />1i <br />VI fQ :F�L <br />BUILDING PERMIT APPLICATION <br />CONTACT FOR PERMIT <br />Phone/E-mail <br />CONTRACT PRICE OF WORK <br />Existing Use of Building <br />HEAT SOURCE: <br />Proposed Use of Building <br />Gas_ Electric_ Other_ <br />Building type: _ Single Family _ Duplex _Townhouse _Multi -Family _ Commer.;ial <br />Type of project: _New —Addition —Remodel _ Repair T.I. _ Sign _Soren ler _Demolilion_Change of Use <br />DESCRIPTION OF WORK (additional space provided on the back): <br />MECHANICAL PERMIT APPLICATION <br />PLUMBING PERMIT APPLICATION <br />Type of Project: _New_Addn _Alteration_Repair <br />Show Number (1) of fixtures <br />Type of Project: _New_Addn _Alteration_Repair <br />Show Number f#) of 8xfures <br />A/C- air handling units <br />L <br />Toilet <br />Forced airs stems <br />Bathtub <br />Gas piping <br />Lavatory (wash basin) <br />Water heater <br />Shower <br />Gas fireplace <br />Kitchen sink & disposal <br />Gas range <br />Dishwasher <br />Clothes dryer <br />Clothes washer <br />Range hood <br />/ <br />Water heater <br />Exhaust fan <br />Sink (service/bar/mop/etc.) <br />Heal pump <br />it Backflow preventer <br />Unit healer <br />Urinal <br />Boiler <br />Drinking Fountain <br />Refrigeration <br />Floor drain <br />Woodstove <br />Grease trap <br />Ducting <br />Roof drains <br />Other <br />Medical Gas <br />SPRINKLER <br />/ SUPPRESSION SYSTEM <br />Other: <br />Number of Heads <br />Other: <br />1 hereby ceday that I have read and examined this application and know the same to be trio and correct. All provisions of laws and ordinances governing this type of "A wit be complied <br />with whether specified herein or not. a granting of a permit does not presume to give authority to vlolato or cancel the prevision of any other slate or local law regulating conslmcgen <br />That I ern o zed by tha r Is pmpetry to perform the work for which application Is made and I comply with the State Contractors Law 16.27 RC W and 296.200A WAC. <br />�II l�`20/� <br />Ownc uthorizotl Agent Signslure Dat (Revised 612012) <br />