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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 />ARE ACCEPTED FROM 8 AM TO 4 PM <br />APPLICATIONS <br />SIT D AoDRES S• PROPERTY <br />�ueP�tt /11A11 �!J S�e•!� <br />TAXX <br />ado 4oa 7oc7 �I <br />/ stet <br />LEGAL far new construction: Short Plat/subdiwsion________Lat <br />No._ (attach copy of long legal desmpuon) <br />`' " 60 Phonel&mail <br />3'1-�/ QO SJA�� 91 rl v <br />FAq)• <br />OWNER [� f —1-/U ./ <br />,(((��� p/• <br />/' <br />Address d3tag llu�t /7 -Ju'F �-13 Gry/Statelbp gdlj /uQ � `sir? 9da <br />APPLICANT:_ Owner _Owner's Agent Contractor Contractor's Agent _Tenantfncm pmrde a ester of comenthommoorrerto daworkinthe space) <br />(/a�t�ltd.(% L/-k',•f� L 861 Lic. k /1--1-L10 Ql toe Bus. uc.;: 0367d <br />�fr�Jl/d7 <br />CONTRACTOR (0 <br />L��Q�CrC7 <br />Address ��yi C- I-1 L. 5(j •!,ALL. U��ir <br />D�%5 PhonelEmail 5(�d-5 E56- 5539e LL7l� <br />TENANT BUSINESS NJAM11E�N <br />CONTACT FOIj,tPERMI�•SE A3 51 'tl Cot y <br />��01L.. ii3JJ�'f•'-J'�39 <br />A) r"! 011 -1;Y5 ,+'—WWC L. <br />�.l �' <br />Phone/E-mail 3�Y <br />@(IC(JJ A% P�..rt/iOCD.(�� <br />PRICE OF WORK %O,D00 <br />BUILDING PERMIT APPLICATION <br />CONTRACT <br />HEAT SOURCE. <br />Existing Use of Building <br />Proposed Use of Building __ <br />y Oas__ Electdc__ Other__ <br />Building type: Single Family _ Duplex _Townhouse _ Multi <br />-Family �1 Commercial <br />_ <br />Type of project: _New __ Addition _Remodel __ Repair _ <br />T.I. _ . Sign __Spnnkler__Demogtion_Change of Use <br />DESCRIPTION OF WORK (additional spat„ provided on the back) <br />hel <br />MECHANICAL PERMIT APPLICATION <br />PLUMBING PERMIT APPLICATION <br />Type of Project: _Addn _Alteration _Repair <br />Type of Project: _New _Addn _Alteration _Repair <br />__New <br />Show Number (M) of fixtures <br />Show Number (0) of fixtures <br />A7C — air handlino units <br />I <br />Toilet <br />Forced air systems <br />Bathtub <br />Lavatory (wash basin) <br />Gas piping <br />Water heater <br />Shower <br />Gas fireplace <br />Kitchen sink 8 disposal <br />Gas things <br />Dishwasher <br />Clothes d r <br />Clothes washer <br />Ran shoo' <br />Waterhealer <br />Sink (service/bar/mop/etc.) <br />Exhaust fan <br />Heat pump <br />Backflow, preventer <br />Unit heater <br />Unnal <br />Drinlang Fountain <br />Boiler <br />Refrigeration <br />Floor drain <br />Grease trap <br />Rdstove <br />Ducting <br />Roof drains <br />Glher____ <br />Medical Gas <br />SPRINKLER /SUPPRESSION SYSTEM <br />other. <br />Number of Heads <br />Other: <br />I hereby certify that I have read and examined this appica bon and know the same to Le true and coned Alp revisions of laws and ordinances governing this type of wa,k will be compied <br />wth er specified herein or not. The granting are permit does not presume to gne authority to violate or cancel the provision of any other state or lout law regulating constmclon <br />That Ia ulhonxed by the owner ofin*property to Perform the work for which appicatlon is made and l comply with the State Contractors Law 1027 PCW and 296200A WAC. <br />.2 ]/�5 <br />(Revised 62012)I <br />COir7 <br />(,0 AJ <br />