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09/^_5/=01- TUE 1?: 19 PAx 425 � 652C laortcreeY. Roofing <br /> �oozioo3 <br /> PERMIT APPLICATION <br /> BUILDING/MECHANICAL/PLUMBING/SIGN/SPRINKLER/DEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 Cedar SL, Everett, WA 98201 425-257-8810 FAX 425-257-8857 tiw�w.ever ltwa.org <br /> APPLICATIONS ARE ACCEPTED FR0618 AM T04 Ph7 � "a7'1 a- <br /> SITE ADDRESS: PROPERN TAX It PERM1IIT� �7 <br /> � Lom�r, .� t�ve. � 0�� <br /> LEGAUoniewwnstruction�. ShnrtPiaUsWtlivision LotNo._ (attachwpyof!ongia�alcesc�D��un) <br /> OWNER �G(�G- 1�'�'.V '\� � Phonel6mail ���-a �� - y��y <br /> Ad'Jress �-Ja� 1..vmbc�r� 'R�e�ve City/StateiZiP GV�.f' �vO �'� <br /> A�PLICANT:_O�+ner ONmer's�gent�Cenlrador Cemractor'sA�ent _Tenantl���+�wwaoainmroiars.,wc�inem�ne,�o���.cr���,inacw:e) <br /> CONTRACTOR Y'� � L&I Lic.il q�rJ,�L9S' �� COE Bus. Lia N�i3 � <br /> �lddress�l�� � � � � ��• S�f'1 ,"l I �'honelEmail yO�S'y�'�q�� <br /> TENANT BUSINESS NAM17E �oN��Fo��y y� ,�� -�qg� <br /> Phcne/E-m�il �JL'[{�,�'\Df��C..Y�CC�\�v'�'n� • <br /> BUILDING PERMIT APPLICATION CONTRACT PRICEOF WORK �qn� <br /> DD <br /> Esis�ing Use of Building �/l v' H[AT SOURCE: <br /> Proposed Use of Building �-v[�.��a�?___ Gas_ Electric_ Olher__ <br /> 6uilding type� Single Family _Duplex_Tcwnhouse _h7ulli-Family _Commercial <br /> T pe of n�o'ect__ New Additionv Remodel Re air T.L Siqn Sorinkler Demolition Chan e of Use <br /> DESCRIPTION OF WORK(add��ional snace provided on Ilie bacFl: <br /> ��� o� c�a reP1�c� co+r�a��-,cm r�o��nc� -`'rw �he Se�-me � or� I <br /> c�Ur-acJ�. on�. <br /> MECNANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> TypeolProjoct: _New_Addn _Altemtlon_Ropair 7ypeofProjea: _New_Addn _Alteralion_Repalr <br /> Show NumGer(p)olOzfu�es Show NwnGer/A)ol/ixturos <br /> A/C-air handling unils Toilet <br /> Forced air s slzms � Bathtub <br /> � Gas pip��9 Lavalory(wash basin) <br /> ;vater heater Shower <br /> Gas firep�ace Kilchen sink 8 disposal <br /> Gas rarge ' Dishwasher <br /> �� Ciothe>d er Clotheswasher <br /> RangF.hood Waler healer <br /> � Gah:.usl fan Sink(servicelbar/mopletc. <br /> � Heat pump � Backfiow prevznler <br /> U.�it healer � Urinal <br /> '� 8oiler � Drinkinq Fountain <br /> Refri.eration � Floor drain <br /> Woodsrove I Grease trap <br /> i Duclin � Roof drains <br /> � Other � Medical Gas <br /> SPRINKLER / SUPpRESSION SYSTEM ! O���er: <br /> ', Number of Heads Other. <br /> :ticieby cerlily Innl I havx rt;:J a:m evarnine01M1:5 Jp.:iGtlien and Ancvr Itic sa me lo I;e hve an�ronecl All F�ovi;ion5 of laws an0 c�Cinen[e5 90vC�0inp Iliis lype ol wo�Y.�c!.::.:��:--{..'J <br /> �adn whelnor speoGe�Iwre�n w nol.T�e granl�np ol a pe�nirt tlonz nol p�esumc lo grve au W on:y lo vlolaW or wncel Ino propisial ol any olner sislo or local law regul31in9 coc;ic-�,.:n <br /> 'hat 1 am aulhorL•e0 by me owner n(iliis pmpeM�o perto�m Ihe woil:lmw5lc�anpikalion is maJe anE I comply w.;0 tlie Slaie Conlrxtois Law 7827 RCW ana 2U820Dn�Y�•'.. <br /> ��,A„��, �C 6Y1� i� , �1 -2� -�� <br /> OvinedAulburizetl A�ent Signature D.�te (rzw`eU 6':��f:'1 <br />