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PERMIT APPLICATION <br />BUILDING/MECHANICAL/PLUMBIINGISIGN/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 />oc ACCE^Tcn FROM R GM TO d PM I / S `/ <br />Hrru..n <br />SITE ADDRESS:.-, <br />PROPERTY TAX If <br />PERMIT x <br />5 <br />�C st =vc, 44 m rr �::e <br />�00S-.s-�� C.3V _ <br />z D-vc <br />LEGAL for new construction Short Plathwbdivision Lot No._ (attach copy of long legal desaiphorf- <br />OWNER 3 - go LCL, <br />PhonelE-mail .2O - o� " // <br />SE -7/ S�- S-f- <br />Cily/SlateZip 5 ,O 40 <br />Address 7S/,S- <br />APPLICANT: _Owner _(Ownees Agent _Contractor Agent _Tenant lmaet p�orde•ka^ol cansenr �ni me °xA1'1000 ^ed'^vi°'0'"el <br />_Comraztor's <br />CONTRACTOR ( T"13h- L 8 I Lic. # COE Bus. Lic. If <br />Phone/Email <br />Address r-drfl(,qld <br />TENANT BUSINESS A79 <br />CONTACT FOR PERMIT <br />191%rsan 1��-� cam¢ S{-act Gr•�P <br />/� <br />/I e--Z� <br />PhonelE-mail C(c-7(n 4ee <br />BUILDING PERMIT APPLICATION <br />CONTRACT PRICE OF WORK <br />Existing Use of Building (� Lv(e i' MEAT SOURCE._ <br />Proposed Use of Building2s �eT ti f Gas_ l_ ee ;r c _ _ otner- <br />Building type: Family — Duplex_Townhouse _ Multi -Family Commercial <br />_Single <br />Type of project New Addition Remodel Repair T.I. Sign Sprinkler Demolition Change of Use <br />DESCRIPTION OF WORK (additional space provided on Me back): <br />�¢ �, rail siz QTcir�,.r S CP AIL L!x• � ) <br />C3o8 5�„,n41nR,II ) <br />pve �. <br />MECHANICAL PERMIT APPLICATION <br />PLUMBING PERMIT APPLICATION <br />Type of Project: _New_Addn —Alteration _Repair <br />Type of Project: _Alteration_Repair <br />_Now_Addn <br />Show Number(#) o/fixtures <br />Show Number (x) of fixtures <br />AIC- airhandlin units <br />Toilet <br />Forced eir s stems <br />Bathtub <br />(wash basin) <br />Gas piping <br />er <br />Water heater <br />en sink & disposal <br />Gas fireplace <br />I washer <br />Gas range, <br />es washer <br />Clothes dryer <br />r heater <br />Range hood <br />(servicetbarlmo letc.)um <br />Exhaust fan <br />I flow reventerUnit <br />KwasnDasm,to <br />lBoiler <br />heater <br />( kin FountainRetd <br />drainWoodslove <br />erationr <br />se trapDuclin <br />f drainsOther <br />ical GasSPRINKLER <br />r:Number <br />/ SUPPRESSION SYSTEM <br />of Heads <br />r <br />I homily cenyy, that I have read and examined this aprebmIm and knew tie same to he Wa and coned. Al provisions of taws and ompances govemng this type of work wdl be compk!d <br />with whether spedkad hemn or not. The graining of a permit does not pmwme to give authority to violate or canal the PoWlSion of any other state or 1=1 law regulating mnstradun <br />Thal I am authorized by the owner of his property to pedorrtl the work for which apphation is made and 1 comply with the State Contractors Law 1 g.27 RCW and 296.200A WAC. <br />(Revised Y2012) <br />