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r__. <br /> ------------ -�_`-- .` � -- <br /> f�ERMlT APPL'�C�4TIDN <br /> 3llILDINGIMECHADJICAL/PLtJMBING/SIGNlSPRINKLER/DEMOLITION <br /> ,,_._ _,--.- --_ GITY OF EVERETT PERMIT SERVICES <br /> 3200 Cedar St., Everett, WA 98201 -425-257-8810—FAX 425-257-8857—www.everett+Na.org/ <br /> qPPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM �l�—I Z <br /> SITEADDRESS: PP.JPEflNTAIfM P MIT71 <br /> IZo l v�¢�ir mau- rJA 2Bosi800'104300 � I <br /> LEGAL for new consWction: Short PlaVsubdivision Lot No._ (attach copy of long legal descriptlon) <br /> OWNER �.�/�,E�i ' Mf.t� -L' Phone/E-mail <br /> Address �3440 11�Nrv�u+ 3 VA SR`- CirylSUte2ip S�J�(LMAN �qC.4S CA Q1�{23 <br /> CONTRACTOR L&ILic.il R�OU-NI 'O�'I�� OD <br /> nddress 9� F�9REDpR- NCE 3s�.Zng MUrIUC-p yY� 9L°L7$ Phone/Email N2S- 344' SoN I <br /> TENANT BUSINES.�i NAME CONTACT FOR PERMIT <br /> �VERILTT rYIhL[.. 1�GA7J4 Phone��-mai�UZS-349-S�V PAT@�Qp�L(pNEON.COM . <br /> BUILDINGPERMITAPPLIC1ITION CONTRACTPRICEOFWORK Z.'��48�•P3 <br /> Existing Use of Building 1"1�� T�ttJ'>V� HEAT SOURCE: <br /> Proposed Use of Building M�y rt T�+��f M Gas__ Eiectiic_ other_ <br /> Building type: _Single Family _Dupiex_Tawnhouse _Multi-Family [�`Commercial <br /> Type ot project: _New _Addilion _Remodel _Repair_T.I.�Sign_Sprinkier_Demoli[ion_Change of Use <br /> Description of Work(atlditional space pmvidedon fbe back�: C � n.n ,.-sT /�LLv/�J f N/���� <br /> U�'�-/"1G�i�:, ��'�I.I'.��[�c�L/}<.t ->/G./ Y�7���1.� . l <br /> Have you sTarted working without a permit9 _YES �NO <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type of ProJect: _New_Addn �Ileralion_Repatr Type of Project: _New_Atldn _Altero:�an_Repatr <br /> Show Number(#)ol�xt�res Show Number(#)ol�xtures <br /> � AIC-airhandlin units I Toilet <br /> j Forced air s slems _ Bathtub <br /> � Gas pipin ( Lavato (wash basin <br /> � Water healer I Sfiower <br /> � Gas fire lace Kitchen sink 8 dis osal <br /> I Gas ran e I Dishwasher <br /> � Clothes d er Clothes washer <br /> � Ran e hood Water heater <br /> � Exhaust fan Sink servicelbarlmo letc.) <br /> � Heat pump I BackFlow preventer <br /> � Unil healer Urinal <br /> � Boiler I Drinkin Fountain <br /> � Retn eration Floor drain <br /> � Woodslove Grease tra <br /> � Ductin Roof dreins <br /> � � Other .tteJ Medical Gas <br /> S[+RIh1KLER/ SUPPRESSION SYSTEIVf otner. <br /> I Number o(Heads � Olhor. <br /> I hereby certify thal I have re�d and ezamirxd this application and knrnv the same to be true and corteU.All provis:ons of laws and ordinances goveming <br /> this rype of work will be complied wth whelher specified herein or noL The graN�ng of a pertnit dces not presume lo give aulhority to violaL=or cancel <br /> the provisio{n�of any olher state or local law regulating conslruction or the pedortnance ot consUuction.Thal I am authonzed by lhe ovmer of this property <br /> to pedo !�qwork for whiU application is made antl I comply with the S:ate Contractors Law 1827 RCW and 296200 WAC <br /> �'7�/���/l� �/t' �'�1 <br /> O erlAuthorizedAgentSi9namre Date (Revised22011) <br /> '`� <br />