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I'ERMIT APPLICATION <br /> SUILnING/MECHANICALIPLUMBINGISIGN/SPRINKLERIDEMOLITION <br /> CffY OF EVERETT PERMIT SERVICES <br /> 3200 Cedar St., Everett, WA 98201 425-257-8810 FAX 425-257-8857 www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM I — `�Z <br /> PROPERNTAX p P MIT# <br /> SITE ADDRESS:1 ,�� � •' _ <br /> 1=v c'k�:TT V L <br /> � <br /> LEGAL lor new conslmction: Short PlaVsubdivision Lol No._ (aUach copy ol lon�legal descripiion) <br /> OWNER l7Alv� I�L <br /> PhonelE-mail '-1z5 • "LH2 � Zym�b ��n��m f�nnaen�a�� <br /> Address �`131 �,.>•�.rmvu.� P��° `��ti Zl O . City/SlatelZip �uCtitr� ; lniA • <br /> APPLICANT:_Owner �' OwnefsAgenl _Conlraclor _ConlraclorsAgent _Tenanllm�+�pmmaeaienormco�s�m�mmmea.�erioao..orx��m.s�a:�I <br /> CONTRACTOR � ' <br /> L&I Lic.# COE Bus. Lic.# <br /> PhoneiEmail <br /> Address <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT 1 �` f� ��`��M <br /> rS�� <br /> +mc_o���t.�os � �S . 4ZS- 4z��_ IyzZ <br /> PhanelE-mail 1�o��vzr � Cor t � Zn . ��r+ <br /> BUILDING PERMIT APPLICATION <br /> CONTRACTPRICEOFWORK i��i� t)C�l� <br /> �� zn��` HEAT SOURCE: <br /> Existing Use of Building �l "� <br /> Proposed Use oi Building `-�^^�� �S nP,:�J� Gas_ Electnc_ other_ <br /> Building type: _Single Family _Duplex,_,Townhouse _Multi-Family�Commercial <br /> T pe of projec.i. _New _Addition _Remodel _Repair_T.I._Sign_Sprinkler_Demolition_Chan e of l�se <br /> DESCRI PTION JF W ORK(additiona�spaco provided on tha back): <br /> ���..0� N� �, l�rT"t.-CZ\Ori— ` <br /> C�t=vpT�:�fv '� . pRiw. �'�(L� IrOC�11=ic.71T1oN � �SC{t-»n-i <br /> O��(7l�Tt /1pn�1lv�� � �1.\° 1-\T"�-�<� `1r�t��\��at.- 1YH(it�o�lS�hG� <br /> 1 � u\'CL{-� !:N \-(1-�l:(l.. � <br /> L�(�C1.�776} I�t]n+J �,an.n -�5�� nA � i <br /> MECHANICAL PERMIT APPLI(:ATION PLUMBING PERMIT APPLICATION <br /> Typo of ProJoct: _Now_Addn _Alteratlan_Ropair Typo of ProJoct: _,New_Addn _Alturatlon_Ropalr <br /> Show Numbcr(N)ol/ixfures Show Number(#)ol lixtures <br /> � A!C—air handting uni�s '�. Toilet <br /> � Forced air s s�ems I Bathlub <br /> � Gas piping I Lavatory(wash basin) <br /> Water healer ; Shower <br /> � Gas fireplace I Kitchen sink 8 disposal <br /> Gas range Dishwasher <br /> � Clothes dryer j Clothes washer <br /> Range hood I Waler heater <br /> Exhaust fan I Sink(service;badmop/etc.) <br /> Heat pump I Backtlow preventer <br /> � Unit heater I Urinal <br /> Boiler I Drinking Fountain <br /> I � Refrigeration I Floor drain <br /> � Woodslove I Grease trap <br /> � Ducting I Roof drains <br /> � Other j Medical Gas <br /> SPRINKLER 1 SUPPRESSION SYSTEM �, Other: <br /> � Number o(Heads i Other: <br /> I here6y cendy Ihal I�ava reatl antl examined ihis apDliwtmn and know Iha samo to be trua entl correct.All provisions ol laws and ordinances Boveming tNs type ot xork x�ll De wmpfed <br /> wlth xfiether spec�etl herein ornol.Tho granling ol a DertnA Eoes not presume lo glva auf�orityto violate or cuncel I�a provision ol any ather state or local law reguleting consirudion <br /> ihal I om ouihotlzeC Dy I�a axner ol t�is pmpetly la pedorm the work for which appliw�ion Is maEa and I comD�Y wR�t�e Slate Contredors Law 1B.P7 ftCW antl 296 200A WAC. <br /> I I� <br /> � �� ,� �2 <br /> OwnarlAuthorizud Agont Signaturc <br /> Date �Revised 6Q072) <br />