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PERMIT APPLICATION <br />BUILDING/MECHANICAL/PLUMBING/SIGNISPRINKLER/DEMOL_ITI,ON <br />CITY OF EVERETT PERMIT SERVICES <br />3200 Cedar St., Everett, WA 98201 420-257-3810 FAX 425-257-8857 w"vw.everettwa.org <br />SITE ADDRESS: PROPERTY TAX N PERMIT A <br />360 S Eae( Ave 5e __ 00145 00701 00 305- 02 <br />LEGAL fornewconstructlon: Sholrtt PlaVsuubndivisiort__Lot No._ (attach cop; of long legal description) <br />OWNER f e✓10fr 17 y1 '1"{'�:4 AMA r4,:.Mail <br />Address 6 n!++ v I tic 7 F Jity/State2ip <br />APPLICANT: —Owner _Owner's Agent ✓ Contractor _ Contractor's Agent —Tenant (must Pronde a miler otamentwm the onerto doworkio the spaco) <br />State Lic. # GRA 16 K P 002 P1 PCity Bus. Lio. # <br />CONTRACTOR r-(1h <br />AI 11W1 1,I <br />Address 7R /. �ptl. ris AN Ave- 54Aw ne W � A Phone/Email yZy• 0•G f' <br />TENANT BUSINESS NAME CONTACT FOR PERMIT <br />Gr"'j 110ri, .. ' , 0- <br />PhonelE•mail <br />BUILDING PERMIT APPLICATION ICONTRACT <br />PRICE OF iYORK 6556 fn , hk <br />Existing Use of Building 5 F k <br />HEAT SOURCE: <br />Proposed Use of Building 5 F k Gas_ Electric_ other_ <br />Building type: V Single Family _ Duplex _Townhouse _ Multi -Family _ Commercial <br />Type of project: _New Addition —Remodel ✓ Repair T.I. -Sign _$rinkler _Demolition_Change of Use <br />DESCRIPTION OF WORK (additional space provided on the back): <br />deck, rebr+r'Id beam jo," t deck e, <br />Ocrtn nneA c1"n'; safe- net 137- oT-t of' er1 .4F,ng <br />anri ra; 15yh}Gr't For oP}r I92 a4 recieck and re.ba ld roi I yysf�M �dr ap r IGSa�4 <br />-F0 Qom i n e �X 5 1 of eek fen4 Prswt1 <br />MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br />Typo of Project: _Addn _Alteration _Repair <br />Typo of Project: _Nnw _Addn _Alteration _,Repair <br />_New <br />Sltosv Number (A) of fixtures <br />Show Number (A) of fixtures <br />A/C - air hancillno units <br />Toilet <br />Forced airs stems <br />I <br />Bathtub <br />Lavatory (wash basin) <br />Gas piping <br />Water heater <br />Shower <br />Gas fireplace <br />Kitchen sink & disposal <br />Gas range <br />Dishwasher <br />Clothes dryer <br />Clothes washer <br />Ran a hood <br />I Water heater <br />Exhaust fan <br />I Sink (service/bartmopletc.) <br />Heat pump <br />BackIlow preventer <br />Unit heater <br />i Urinal <br />Boiler <br />I Drinking Fountain <br />Refri eration <br />Floor drain <br />Woodslove <br />Grease trap <br />Ductin <br />Roof drains <br />Other <br />Medical Gas <br />I Other: <br />SPRINKLER I SUPPRESSION SYSTEM <br />Number of Heads <br />Other: <br />i hereby costly that I have read and examined this application and know the some to be We and toned. AN provisions or laws and ordinances governing this type of work will be wmpled <br />with whether specified herein or not. The granting of a pennd does not prosume to give authortly to violate or canoel the provision of any other state or local law regulating wnstrudion <br />That I am authored by the owner of this proPerty to perform the work for which e109114-AW is made and I campy with the State Contractors Lew IS 27 RCW and 296.20DA WAC. \ <br />Plrzr A ki-) S�l) 13 <br />Owner)Autho bd AgentSignature Date (Revised 320r3) <br />