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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.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM —K" <br />SITE ADDRESS: I L1o2 5E L-'j,'( N-fj-"M We' <br />PROPERTY TAX2c`3�sl <br />PERMIT• —& <br />LEGAL for new construction: ShortPlaUSubdivision Lot No._ (attach copy of long legal description) <br />rn� OWNER J `& �c`ST EU4SGt"'LLk^c t L L C <br />PhonelE-mail <br />Address 16lob �� h4S`'`'te`� S4F— ,1'oo <br />�t n <br />City/5tatelZila `�Q �A Qek61;2- <br />APPLICANT:_Owner _Owner's Agent Contractor _ Contractor's Agent Tenant lmmtprvadeamrer etrmsemhom aw over to ao work in V,e ipaa) <br />-Es I U'� 3 iU <br />L 8 I�1Lic. # R�AG3 8 W E COE Bus. Lic. # <br />- <br />CONTRACTOR vt <br />G� <br />C' <br />Adtlress iC.�vO (4c'"' `�sU c'4� ��T �u �n4 PnonelEmail3�o-Y2l(-1325-,b,1�PWf./p(-,Sf'N• c <br />TENANT BUSINESS NAME <br />CONTACT P�E/7R�M/I I f7 i I � ktc <br />L A <br />�IFOK <br />�,l1R('l2SSl'llit,•Co <br />v lT <br />PhonelE-maiL]Or--r"•1'13i1�s <br />BUILDING PERMIT APPLICATION <br />CONTRACT PRICE OF WORK ,LIC-22 "'— <br />Existing Use of Building ­9-11ckt k <br />I HEAT SOURCE: <br />Proposed Use of Building 2eIw, Gas_ Electric_ Other_ <br />Building type: _ Single Family _ Duplex _Townhouse _ Multi -Family ZCommercial <br />Type of project: 4New Addition Remodel Repair T.I. Sign _Sprinkler Demolition Chan a of Use <br />DESCRIPTION OF WORK (additional space provided on the <br />``back): <br />No Cs � 1 <br />1N5 f LI ,AuLA—zlluw��Tc� Avtnr�Lcl� ��csff <br />JJ <br />i e rT <br />MECHANICAL PERMIT APPLICATION <br />PLUMBING PERMIT APPLICATI"1N <br />Type of Project: _New_Addn _Alteration_Repair <br />Type of Protect: _Now_Addn _Alteration _Repair <br />Show Number (#) of fixtures <br />Show Number (#) of fixtures <br />A)C— air handling units <br />I <br />Toilet <br />Forced airs stems <br />Bathtub <br />Gas pipin <br />Lavalo (wash basin) <br />Water healer <br />Shower <br />Gas fireplace <br />Kitchen sink 8 disposal <br />Gas range <br />Dishwasher <br />Clothes dryer <br />I <br />Clolheswasher <br />Range hood <br />Water heater <br />Exhaust fan <br />Sink (service/bar/mop/etc.) <br />Heat pump <br />I Backflow preventer <br />Unit heater <br />Urinal <br />Boiler <br />Drinkin Fountain <br />Refrigeration <br />Floor drain <br />Woodstove <br />Grease trap <br />Ducting <br />Roof drains <br />Other <br />Medical Gas <br />SPRINKLER / SUPPRESSION SYSTEM <br />Other: <br />Number of Heads <br />Other: <br />I hereby certify met I have read and crammed this application and know the same to be true and correct. WI provisions of Laws and ordinances governing this type of work will be complied <br />wdh whether specified herein a not. The granting of a permit does not presume to give aumonty to violate or cancel the provision of any other state or local law regulating construction <br />That I am authonzed by the owner of this property to perform the "A for whim -la application Is made and 1 comply with the Stale Contractors Law 18.27 RCW and 296.260A WAC. <br />51 ' <br />��NA ly-3C-3--I--Z, <br />Owner/Authorized Agent Signature Date (Revised 6/2012) (/L <br />