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PERMIT APPLICATION <br /> BUILDINGIMECHANICALIPLUMBING/SIGNISPRINKLER/DEMOLITION <br /> CITY OF EVERE.TT PERMIT SERVICES <br /> 3200 Cedar St., Everelt, WA 98201 425-257-8810 FAX 425-257-8857 www.everettwa.org <br /> ApPLICAT10N5 ARE ACCEPTED FROM 8 AM TO 4 PM �'j `—I� `"�Z <br /> SITE.ADDRESS: /� `fBL� PROPERNTA%N P�MIT# _ ` <br /> l—f w, LT�cn ��✓_ '��' <br /> LEGAL for new constmction: ShoA PlaVsubd!vision <br /> �� q,vY�l Lot No.�/ (allach:opy of long leqal descdption) <br /> OWNER �(�'L � � � � r PhonME-mail ,I <br /> Address '�I p "J tj �^� 1 Ch �'14Ut"I V CirylStalelZip �✓C��i/T �'�/" / �v� � <br /> APPLICANT:_Owner CwnersAgenl _Conlraclor _ConUactor'sAgent _Tenanllm�:�v�o���aeaie���roiw�.miwmme�wne�ioaoM�o�x��omespa:e� <br /> CONTRACTOR Co���r„�o� ��` � L&I Lia# COE Bus.Lic.# <br /> Address "(6Z� �`� ��f•� "! 5i���' �r Ph�nelEmail <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT <br /> [�zS- _353- y7a� <br /> PhonelE-mail -/ <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK `5���+� <br /> � �� HEAT SOURCE: <br /> Existing Use o(Building C <br /> Proposed Use of B�uilding J �� Gas,_ Electric Other__ <br /> Building type: ✓Single Family _,Duplex Townhouse _Mulli-Family _Commercial <br /> Type of project: New _Addition •� Remodel _Repair_T.I._Sign_Spnnkier Demolition_Change of Use <br /> DESCRIPTIONOFWORK�additionolspacepmvide ontheback):�/ � wG /� a Q ��/�—O. V�p�t�� �� <br /> L �/GH /l/�� ��Z, �tGG � ! � h('/l / `1 " �� � <br /> �'Ll O V C� T \ • !' r.y.� <br /> / ) � �� r <br /> NG�✓ �-�7L`lt-� C'���: ��ovf`t �a��, ��•- �� �'S -�.,� � • <br /> MECliANICAL PERMIT APPLICATION PLUMBING PERMIT A PLICATION <br /> Typo of ProJuct: _New_Addn _Aileratlon_Repair Typn of Project: _New,_Addn _A�teration_Repair <br /> ShowNumbcr(N)offiafures <br /> Shmv Numbcr�k)o!fixfures Toilel <br /> � A/C—air handling unils � � palhWb <br /> � Forced air systems � <br /> � Gas piping i Laeatory(wash basin) <br /> I Water healer � Sho�ver <br /> � Gas 5replace � Kitchen sink&disposal <br /> � Gas range � Dishwasher <br /> � Clolhes dryer , Ciolhes washer <br /> Range hood � Water healer <br /> Exhausl fan � I Sink(service/bar/mop,'elc.) <br /> Heal pump I Backflow preventer <br /> � Unit healer I Unnal <br /> Boiler I Drinking Pountain <br /> � Refrigeration I Floor drain <br /> Woodslove Grease lrap <br /> Ducling I ftoe(dreins <br /> Olher � Medical Gas <br /> SPRIIVKLER / SUPPRESSION SYSTEM I Olher: <br /> Number of Fleads I Other. <br /> I hereby cetlify I�at I hava reod anA eK�mined this epphcation nnd know�he sume to be Irue end cormd.All prrnisions cl la,vs and ord�nancee gevemi�g this type ol�vork�cdl ba compPetl <br /> �cuh whelM1er specified herein or nol.Tha granling ol a pe�mtl tloes nol presuma lo gNe authoriry to violate or cancel�he pmvision ol any olher state or lowl law regulaling mnstrua,on <br /> 7 hat I am aut�orizetl by Iha oxner al thls property lo pertorm I�e�ro�k'er�s�ich appilcation Is matlo and I mmply witli the Stcle Contraclors Law 1917 RCW anC 2962WA VJAC. <br /> .���'��.�� ��//- / z. <br /> j .o....:��d rnn�oi <br /> _ _ . . .�.' _. . _ ' <br />