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!-�RMIT APPLICATION <br /> BUILDINGIMECHANICALlPLUMBINGISIGN/SPRINKLER/DEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 Cedar St., Everett, WA 98201 -425-257-8d10—FAX 425-257-8857—www.everettwa.org <br /> ApPLICATIONS ARE ACCEPTED FROM 0 AM TO 4 PM <br /> PROPERTY TAX H .4ER�AIT#� <br /> �UL`WN S-��L�. -� q oo��o soo � � - c�ai <br /> LEGAL for new conslruction: Shod PlaUsubtlivislon� �N�� Lol Na._ (altach copy ol long legal descriplion) <br /> OWNER �Q� 1�roL,s � i�.Jl „�S PhonelE-mail 'l�"290•Z�{'Lq 'oelQhnc�ckhR�j,(U/^t <br /> Address ��Z2 p�+l rI� /v� Ci�YlStatelZip (�f 3V��� Wt�"1 . `� �Z�d <br /> CONTRACTOR �(,10.Ck � Yc�$, 1 vM2s L&I Lic.# QUck II �o ►2 Z <br /> Address�j42.Z �1rr�� �E /I I�� SV�IIe ` $��� PhonelEm�il �-2.���'Zy2 / <br /> TENANT BUSINESS NAME . ���� �.{C\�CKT J L.�,CJ�����k�IIA'S�CU. <br /> C <br /> ' PhonNE�mail LS=Z�fV'2y2�� <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK � 3O K <br /> HEAT SOURCE: <br /> Exisling Use of Building <br /> Proposed Use ol6uilding S r� Gas� eiec�ric_ Other_ <br /> Building lype: �Single Family _Duplex_Townhouse _Multi-Family ,_,Commercial <br /> Typeofproject: �,New _Addltlon _Remodel _Repair_.,T.I._Sign_Sprfnkler_Demolition_Change ofUse <br /> Descnplion of Work(additional space providedon fhe back): <br /> NC� SF� �s..,;-1-h L.k-k�.c4�e` 9 R�c.�qe <br /> Have you started working without a permft7 _YES�NO <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Typo of ProJoct: �Now_Addn _Alteration_Ftopair Typo oi ProJect: _Now_,Addn _..,Alleratlon_Ropair <br /> Show Number(N)o//ixtures Show Number(N)ol flxtures <br /> A/C-air handling units __ Toilet <br /> Forced air systems Bathtub <br /> Gas piping Lavatory(wash basin) <br /> Water heater ( _ I Shower <br /> �_ Gas fireplace � I Kilchen sink 8 disp—osal � <br /> 1_ Gas range Dishwasher <br /> � Clothes dryer _(_, � Clothes washer <br /> Range iiood � <br /> Exhaust fan _ Sink(service/bar/mop/etc.) <br /> Heat pump _ � Backflow preventer <br /> Unit heater _ Urinal <br /> � Boiler _ Drinkirg Fountain <br /> Refrigeralion _ Floordrain <br /> Woodstove _ I Grease trap <br /> � Ducting _ Roof drains <br /> Other _ Medical Gas <br /> SPRINKLER / SUPPRESSION SYSTEM _ Other <br /> Number ol Heads — <br /> I hereby certi(y that I have read and ezamined this oplicalion and know the sama to be true and correcl.All pmvisions w laws and ordinances governing <br /> this type ol work will be complied with whether specifed herein or nol Tho granling ol a permit does not presume lo give authoriry lo violale or cancel <br /> the provision ol any other sfate or local law reguialing conslmction or Ihe pertormance ol consiruclion.Thal I aT authonzed 6y lhe o�mer ol lhis pmperty <br />• dor�Ihe wo fo wh h application is made and I comply with the Stafe Contraclors Law 1827 RCW and 296.200 WAC <br /> '� � ia q 20� <br /> Date (Revised 7Y2010/I <br /> Ownur kod p 51 aluro � � <br /> � <br />