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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 www.everettwa.org <br />SITE ADDRESS: C / / <br />L <br />PROPERTY TAX <br />l�nl 0 <br />05_ <br />LEGAL or now construction Shod Plat/suuod,vision Lot No _ !attach copy of long legal destnptun) <br />OWNER <br />Phone/E-rnad <br />Add,ev, <br />C1ry/S1atelLp <br />APPLICANT:_ Ovine: _-Owne's Agen' _Contractor _ConuaRo/s Agent Tenant rmrfllrmle al-:er otcm+entfvn u+a.wueo wv nine +Pami <br />CONTRACTOR 1qJajq0tt1State <br />Lic rt aAAfYM / 010i'llf City Bus. Uc. # <br />Add rss , / T— <br />PhondEmad Vc(- 37( - &'773 cant el ty <br />TENANT BUSINESS NAME <br />CONTACT FOR P RMIT V C1a . i <br />lPhone/E.mail US--) 71, f—?S <br />BUILDING PERMIT APPLICATION <br />CONTRACT PRICE OF WORKjf�Od <br />Existing Use of Building HEAT SOURCE <br />Proposed Use of Building Gas ✓ Electric Other <br />Building type _ Single Family _Duplex _Townhouse —Multi-Family Commercial <br />Type of protect: New Addition Remodel Repair ✓T.I. Sin Sprinkler Demolition Change of Use <br />DESCRIPTION OF WORK (addhonal spaceprowled on the back): / <br />V e&u /?celziz�-p 24l(141 C eu:f ltt eZ4� <br />MECHANICAL PERMIT APPLICATION <br />PLUMBING PERMIT APPLICATION <br />Typo of Project _New_Addn _Alloratlon_Repair <br />Show Number tl of rixturos <br />Typo of Project: _New_Addn _Alteration_Repair <br />Show Number p of fixtures <br />I <br />A/C — au handling units <br />I Toilet <br />_ <br />Forced airs stems <br />Bathtub <br />_ <br />Gas piping <br />Lavatory wash basin <br />Water heater <br />Shower <br />Gas fireplace <br />Kitchen sink 8 disposal <br />Gas range <br />Dishwasher <br />Clothes dryer <br />Clothes washer <br />Range hood <br />Water heater <br />Exhaust fan <br />Sink servicelbartmo lelc. <br />Heat pump <br />Backflow preventer inside bid <br />Unit healer <br />Unnal <br />Boiler <br />Dnnkinq Fountain <br />Refrigeration <br />Floor drain <br />Woodstove <br />Grease trap <br />Duchn <br />Root drams <br />Other <br />Medical Gas <br />SPRINKLER / SUPPRESSION SYSTEM <br />Other <br />Number of Heads <br />Other: <br />I heretry cenxy Nat I have read and esammed this apprxanon and know the same to be We and anect All previsions of laws and ordinances governing this type of work vM be comp! <br />w+lh whether Sheared herein or nor. The granting of a permil dons not presume to due authomy, to violate or cancel Ne pravaon of any other state or local law regulating construction <br />That i am authd ed by the er of inn Perry to perform Me work for wnrcn apphcawn a made and I romply VIM Inc State Contractors Law IB 27 RCW and 296 200A WAC <br />sir-s `(v <br />Own rlAuthor¢ed Agent Signatur T¢ (Revised 4/t015) <br />