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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 />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM D G —I Z <br />SITE ADDRESS: SE Eyo tea-# I)1 rr �I �L <br />p2SEC'S AC# no3-o3 —oe <br />iU' <br />LEGAL for now construction: Short Plat/subdivision Lot No._ (attachcopyof long legal description) <br />OWNER 97 -'"v, L'GL <br />Phone/E-maile2U(p-.ZJlo-8-27 <br />// <br />Address �,j /s E 1 _-�T <br />..S <br />City/StatelZiP !Ls/' .r..w �, ♦_ -. 4 r%u0c• �.:7 <br />APPLICANT:_ Owner Owners Agent Contractor _Contractors Agent _Tenant (must pevide. lettarotopmem from the 000erto dawvAbtheepaw) <br />CONTRACTOR �0) V V I <br />I X <br />L & I Lic. # COE Bus. Llc. # <br />Address Vdmart,d, Phone/Email <br />TENANT BUSINESS NAME <br />_ 7 <br />G-.t✓r:- ��,z«c � <br />CONTACT FOR PERMIT / <br />A1)rsan 1I­�Lav/7 -. C--•''.L S%ct:�s C'rr'H--� <br />Phone/E-mall ��i y tit (�' <br />BUILDING PERMIT APPLICATION <br />CONTRACT PRICE OF WORK <br />Existing Use of Building <br />HEAT SOURCE: <br />Proposed Use of Building=l,"-i � "•-n Gas_ Eleddc_ Other_ <br />Building type: _Single Family _ Duplex —Townhouse _Multi -Family kCommercial <br />Type of pro'ect: _New _Addition _Remodel _ Re air _ T.I. Si n _S rinkler Demolition_ Change of Use <br />DESCRIPTION OF WORK (additional space provided on the back) : <br />>N1o/r-r/ <br />-4 �ve�L�t. <br />MECHANICAL PERMIT APPLICATION <br />PLUMBING PERMIT APPLICATION <br />Type of Project: _New_Addn _.Alteration __Repair <br />Show Number (#) of fixtures <br />Typo of Project: _Now__Addn _Alteration_Repalr <br />Show Number (#) of rixrures <br />A/C - air It milling units <br />Toilet <br />Forced airs stems <br />Bathtub <br />Gas piping <br />Lavatory (wash basin) <br />Wafer heater <br />Shower <br />Gas fireplace <br />Kitchen sink & disposal <br />Gas range <br />Dishwasher <br />Clothes dryer <br />Clothes washer <br />Range hood <br />Water heater <br />Exhaust fan <br />Sink (service/bar/mop/etc.) <br />Heat pump <br />Backflow preventer <br />Unit heater <br />Urinal <br />Boiler <br />Driming Fountain <br />Refrigeration <br />Floor drain <br />Woodstove <br />Grease trap <br />Ducting <br />Roof drains <br />Other <br />Medical Gas <br />SPRINKLER If SUPPRESSION SYSTEM <br />Other: <br />Number of Heads <br />Other: <br />I hereby c ity that I have read and examined this application and know the some to be true and=neet. An pmvi!bns or lam and ordinancesgoveming this type of work will be compled <br />with whether specified harem or not. The granting of a permit does not presume to glue outhonty to vlelete or cancel the provision of any other state or focal ler'regulating construction <br />That I am authorized by the owner of this property to Parton the work for which application Is made and 1 compN with the State Contractors Law 1B 27 RC W and 299.200A WAC. <br />Owner/Authorized Agent Signature Date (Revised r12012) <br />