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PERMIT APPLICATION <br /> BUILDINGIMECHANICALIPLUMBINGISIGN/SPRINKLER/DEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 Cedar St., Evere" ',NA 98201 -425-257-8810—FAX 425-257-8857—www.everettwa.org <br /> MPPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> PROPERTY TAX k PERMIT t <br /> ��AL`fON ST��C—'T 9 OO�'IO $�OO - 1 <br /> LEGAL lor new conslruction: Shcrt PlaVsubdivision �l��.H�1� Lol No._ (atlach copy of long legal description) <br /> OWNER �o,ack l�ros. �"nES PhonelE-mai19LS-29o�a4t9 'eel@hu!�ckhz�-I�ers,c�� <br /> Address 3q2Z s�I+r A�c N� Ciry/Stale/Zip {�(�� SU��� �..VP'1 � �'1 g2-�d <br /> CONTRACTOR (aQCk � nc $, ' �.+•`eS L81Lic.# ac�.ck II �o �z Z <br /> Address392z. p1�k�J� •tl�' �L� SU��'� (�27�1 Phane/Email �-Z��-ZyZy <br /> TENANT BUSINE55 NAME ����i F��`�,��T J����yX�q�ktro-Il�t-s,(u. <br /> Pho e/E-maif LS 2Y�-2�2y <br /> BUILDINGPERMITAPPLICATION CONTRACTPRICEOFWORK ��OOp <br /> Existing Use of Building HEAT SOURCE: <br /> Proposed Use of Building Gas_ Eiectric_ Other_ <br /> Buildingtype: _SingleFamily _Duplex_Townhouse _Multi•Family _Commercial <br /> Type of project: _New _Addition _Remodei _Repair_T.I,_Sign_Sprinkler_Demolition_Change of Use <br /> Description ot Work(addifianal spaco provided on fhe 6ack): <br /> ���l�sh ���5 �-;ny SFR � �Qe•}-c�ctie � yc��raye- <br /> Have you started working without a permit7 _YES _NO <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Typo of ProJect: _New_Adtln _Alteration_Ropair Typo oi ProJoct: _New_Addn _Alterallon_Repair <br /> Show Namber(H)of/ixturcs Show Numbcr(p)o/fixturcs <br /> � A/C-air hand'ing units _ Toilet <br /> Forced ar systems Bathtub <br /> Gas piping _ Lavatory(wash basin) <br /> Water healer Shower <br /> Gas freplace Kitchen sink&disposal <br /> Gas range _ Oishwasher <br /> Clothes dryer _ Clothes washer <br /> � Range hood _ Water heater <br /> Exhaust fan Sink(service/bar/mop/etc.) <br /> � Heat pump BackFlow preventer <br /> � Unit heater __ Urinai <br /> � Boiler _ Drinking Fountain <br /> Refrigeration Floor drain <br /> Woodsrove Grease trep <br /> Ducting Roof drains <br /> � Other _ Medical Gas <br /> SPRINKLER / SUPPRESSION SYSTEM _ Other <br /> Numbcr of Heads <br /> I hereby certity lhat I have read and examined this application and knmv Ihe same to be true and cortect.All provisions ot Iaws and ordinances govemin9 <br /> Inis type of work witl be complied with whether specified herein or not.7he granting of e permit does not presume to giva aulnorily to violate or cancel <br /> the provision of any olher slale or lo al law regulaling conslmction or Ihe peAormance ol consWclion.That I am authonzed by Ihe owner ol lhis pwpeny <br /> lo m ih o k foi wli h a lic��on is made and 1 comply with the Slate Contractors Law 1827 RCW and 296.200 W�C <br /> 10 �r Z� IZ <br /> O edA n e AgentSi �rc Date (Fevi:;ed7Z20%O) <br />