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PERMIT APPLICATION <br />BUILDING/MECHANICAL/PLUMBING/SIGN/SPRINKLER/DEMOLITION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 Cedar St., Everett, WA 98201 425-257-8810 FAX 425-257-8857 vNAV.everettwa.org <br />APPI !CATInNs ARF ACCEPT"ED FROM 8 AM TO 4 PM )/ <br />SITE ADDRESS: <br />I LIOZ SE Cl/G r I1 4LL t )I! 5 tl7t 3�Z <br />PROPERTY TAX # <br />2 X' G <br />ERMIT i .ram„., <br />DO <br />LEGAL for new construction: Short Plat/subdivision Lot No._ (attach copy of long legal description) <br />OWNER STEAD Le¢l_ F/ F E <br />Phone/E-mapil qtr - Ez-7 <br />/�100 UO I V Sr! E¢ <br />la/ZiG)Z <br />Cty/SeAddress <br />APPLICANT:_ Owner _Owner's Agent Contractor Contractor's Agent Tenant(must provide a letter ifconsenl from the omer to do via* in the space) <br />CONTRACTOR li, -/:1 ' t <br />!/ <br />3 L & I Lic. # �r� —1'1�1 yp3`�{v�lc,� COE Bus. Lic. # 1 <br />,At // /y]].......�! <br />Address �(��}�,, ) � IVY Y.ip] liga 1. A 27- Phone/Email �ZS pp,p-`jZ2 <br />TENANT BUSINESS NAME <br />GA�rU55 <br />CONTACT FQpR PERMIT <br />011 C4 AFy ATl�Wli <br />PhonetE-mai(qZS)3-gzz4x12bS n TiJw9 AIEL 4tECNANrG4GC <br />BUILDING PERMIT APPLICATION <br />CONTRACT PRICE OF WORK Z I'UllouPuti�zl�y <br />Existing Use of Building •t^7 Cl r ltt t HEAT SOURCE: <br />Proposed Use Of Building Gas_ Electric_ Other_ <br />Building type: _ Single Family _ Duplex Townhouse _ Multi -Family --4-Commercial <br />Type of pro'ect: New Addition Remodel Re air T.I. Sin Sprinkler _Demolition Change of Use <br />DESCRIPTION OF WORK (additional space provided onthe back)::[N57-NLL(I)O-U aOvF7W (arolTl (1)Cyk�t,STrAl <br />DU67'WALILy Afvb FQL v�,6r44 Fv2 771. <br />MECHANICAL PERMIT APPLICATION <br />PLUMBING PERMIT APPLICATION <br />Type of Project: _New _-Addn _Alteration _Repair <br />Show Number (#) of fixtures <br />Type of Projecn _New _Addn _Alteration _Repair <br />Show Number (#) or fixtures <br />I A/C — air handling units <br />! <br />Toilet _ <br />Forced airs stems <br />Bathtub <br />Gas piping <br />1 <br />Lavatory (wash basin) <br />Water heater <br />Shower <br />Gas fireplace <br />Kitchen sink & disposal <br />Gas range <br />Dishwasher <br />I Clothes dryer <br />Clothes washer <br />Ran a hood <br />Water heater <br />I <br />Exhaust fan <br />I <br />Sink (service/bar/mopletc.) <br />I Heat pump <br />Backflow prevemer <br />Unit heater <br />Urinal <br />Boiler <br />I <br />Drinking Fountain <br />Refri eration <br />i 1 <br />Floor drain <br />Woodstove <br />Grease trap <br />DuctingRoof <br />drains <br />Other <br />Medical Gas <br />SPRINKLER / SUPPRESSION SYSTEM <br />Other: <br />Number of Heads <br />Other: <br />I hereby certify that I have read and examined this application and know the same to be true and correct. All provisions of laws and ordmam.es governing this type or work will be complied <br />with whether speed heroin or not. The granting of a permit does not presume to give authority to violate or canoe! the provision of any other state or local law regulating construction <br />That l am au onzed by the owner of this property the work for which application is made and l comply with the State Contractors Law 18.27 RCW and 296.200A WAC. <br />Owner/Authorized Agent Signature ale (Revised 62012) <br />