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PERMIT APPLICATION <br /> f3UILDING/MECHANICALIPLUIVIBING/SIGN/SPRINKLER/DEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES 6 �(G��l3 <br /> 3200 Cedar St., Everett, WA 98201 425-257-8810 FAX 425-257-8657 www.everettwa.org <br /> SITE ADDRESS: �� / O � r PROPERTY TAX p � O �O�/�/,� PER%IT R <br /> V <br /> LEGAL lor new wnstruction: Short PlaUsubdivision /�� �///A���Lot No��_33(allach copy ol loog Iegal descriplion) <br /> OWNER. /E,'' � Phonc/E-mail J6 �S �/ s /�� <br /> Address f, � % /� �p City/Statc2ip � /Q ,J �7 Cv�' <br /> , <br /> APPLICANT: Owner OwnefsAgenl Contractor CoMraclor'sAgenl TCnO�i(must0�o.+0oalenoratmnsem`nmmoo+nertaaowc�knmospaw) <br /> CONTRACTOR C � �/� � L 8 I Lic.# U Nd COE Bus. Lic. # <br /> Address Os r� C[ Q % PhonelEmail Q ' <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT <br /> fR�/,7 /9h'.E"SKC � 6/jt,� i! o C�/2' <br /> Phon^!E-mail ��6 J/S <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK 2� `� 7�I <br /> Existing U��of Building HEAT SOURCE: <br /> Proposed Use of�uilding /U.�/(� S /�t�i� � f.OA�/.�✓ /Q�-r� Gas Eiearic_ Other_ <br /> �wlding type: �Single Family _Duplex_Townhousc _Mulli-Famlly _Commerciai <br /> Type of pro'ecl: �_( New _Addilion _Remodel _Repair_T.I._Sign_Sprinkler_Demolilion_Change of Use <br /> DESCRIPTION OF WORK(addifional spaca pmvided on Iho back)' <br /> C D N�S�iQ G�,C% /v,llt/ S//1/F� E Fi0`IJ//1� /�Lc's� <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Typo of ProJoct: �Now_Addn _Altcratlon_Ropalr Typo ol PraJoct: �Now_Addn �Altoration_Ropair <br /> Show Numbcr(a)ol�xtures Show Number(p)ol liztures - <br /> A/C-air handlin units Toilet <br /> / Forced air s stems Bathtub <br /> Gas piping Lavatory(wash basin) <br /> Waten c�ater Shower <br /> Gas fireplace J Kitchen sink 8 disposal <br /> Gas range Dishwasher <br /> � Clothes d er Clolhes washer <br /> Range hood — <br /> [xhausl fan Sink(servicePoadmop/elc.) <br /> Heal pump Backllow preventer <br /> Und healer Urinal <br /> Boiler Drinking Founlain <br /> Refrigeralion Floor drain <br /> Woodstove Grease trap � <br /> Ducting � Roof drains <br /> Other Medical Gas <br /> SPRINKLER / SUPPRESSION SYSTEM Olher: <br /> Number of Heads Olher: <br /> I hcrcEy ceMy 1�a1 I�avc rca0 and ew�mineC I�is appl¢aUon anC knaw thc samc lo Cc Iruo antl wrtcd..Vl pmvisions ol I.rvs antl ortlinancef poveminq tM,lypc ol wotk wll�c campJetl' <br /> wA�MncOicr sDcufed herein or not The 9nNing of n pertrcl Coes nol prcsume lo gNe aut�ority to vrolate or wnul ttio provi;ion ol ony oser sute or lowt lav mgulating constmnian . <br /> That I am authcdred by Ihc owncr of thie D�Pcrty to pertortn Inc wad foi whiU�appliwtion is maCc on01 compty wAh tho Stata Convaaors Law 18 27 RCW enC i9G 700n WAC. ; <br /> �/��/�,��� .,�v_� � y- ��� ' <br /> l� .���=f /- .2 /_� <br /> OwnmlAuthoNxotl Agont Signaluro Dafe (Revised 1�1U1J) � <br />