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PERMIT APPLICATION <br />BUILDINGIMECHANICAL/PLUMBING/SIGN/SPRINKLER/DEMOLITION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 Cedar St., Everett, WA 98201 425-257-8810 FAX 425-257-8857 www.everettwa.org <br />APPLICATIONS ARF ACCEPTED FROM 8 AM TU 4 PM <br />SITE ADDRESS: <br />L30� '5 �Ve­-�(�M I�L�Y�v <br />PROPERTYTAX# <br />2SoS/8-003-03�- <br />PE MIT# <br />I?AO OZ <br />LEGAL for new construction: Short Plat/subdivision Lot No. (attach a)py of bng legal description) i <br />OWNER 3- c- <br />PhcnelE-mail o20(p- o 21c- / / % 2 <br />// <br />Address ?r-/S S� %/ S>t S-r <br />CityfStaterZipL) <br />ei (u /-tISO4�© <br />APPLICANT: —Owner OwmersAnent Contractor Contractor's Agent —Tenant lawsomvdseemro�x^t^a^m^mK"ee°"°enue°p°<1 <br />CONTRACTOR (TU D) <br />L & I Lic. # COE Bus. Lic. # <br />Address Phompffimail <br />TENANT BUSINESS NAME <br />�Tkfl).Pja_ 460-e c <br />CONTACT FOR PERMIT <br />glhs�n &Z-n , corc- <br />PhonefE-mail <br />BUILDING PERMIT APPLICATION <br />CONTRACT PRICE OF WORT( <br />Existing Use of Building <br />HEAT SOURCE: <br />Proposed Use of Building Gas FJecbic_ Other_ <br />Building type: _ Single Family _ Duplex_Townhouse _ Multi -Family —Commercial <br />Typeof ro ect: New Addition Remodel Re air T.I. Sin S rinkler Demolition Chan a of Use <br />DESCRIPTION OF WORK (additional space provided on the back): <br />Irt 5 Pa 11 Ajs. iti'�.�'la.'I c cu-i 'L'n f (s r n r1.�.W nLWLcr-r cc�- C7 u /laC4ty <br />MECHANICAL PERMIT APPLICATION <br />PLUMBING PERMIT APPLICATION <br />Type of Project: )' New_Addn _Alteration_Ropair <br />Show Number (A) i1 fixtures <br />Type of Project: New_Addn _Alteration _Repair <br />Show Number (#) of fixtures <br />A/C - airhandlin units <br />Toilet <br />Forced airs stems <br />Bathtub <br />z <br />Gas pipin <br />Lavato (wash basin) <br />Water heater <br />Shower <br />Gas fireplace <br />Kitchen sink & disposal <br />- <br />Gas ran a <br />Dishwasher <br />- <br />Clothes dryer <br />Clothes washer <br />Ran ehood <br />Water heater <br />Exhaust fan <br />Sink (servicelbarlmopletc.) <br />Heat pump <br />Back1low preventer <br />Unit heater <br />Urinal <br />Boiler <br />Drinkinq Fountain <br />Refrigeration <br />Floor drain <br />— <br />Woodstove <br />Grease trap <br />j <br />Ducting <br />Roof drains <br />- <br />Other <br />Medical Gas <br />SPRINKLER / SUPPRESSION SYSTEM <br />Other. <br />K: <br />Number of Heads <br />Other: <br />I hereby candy that I have read and exammed th's appintion and know the same m be true and mired. AN previsions of laws and omnanoes geveming this type of work wit be complied <br />wdh Whemor specified herein or not. The grantng of a permit does not presume to ghe authority to violate or cancel the provision of any other state or 1=1 law regulating construction <br />That I am authorized by the owner of this property to peAome the vmrk for Which appicaWn Is made and I comply with the State Contractors Law 18.27 RCW and 298.200A WAC. <br />1) /2C 0I/L <br />� <br />Owner/Authorized ftdnt signature Date (Revised 82012) <br />