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PERN9IT APPLICATiQN <br /> BUILDINGIMECHANICAL/PLUMBINGISlGNISPRINKLERIDEMOLITIO"� <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 Cedar St., Everett, WA 98201 425-257-8810 FAX 425-257-8857 www.evere�a.'r��/� <br /> . .. � ��:.'�:�� PE li� ( <br /> • PROP ,�.�.,_'�:' ' . , �� <br /> SITE ADDRESS:� A . ! ..,, ' — <br /> �e�, i•rv .. . .... .... .. �..., <br /> LEGAL for nevr conslruclion: Short PIaL'subdivision <br /> Lot No._ (attach copy of long legal description) <br /> OWNER � � J �Y�`"� `_ E PhonelE-mail <br /> Addmss L yv� � ,I'{' CilylStafelZip�'�Je�,� V�[� C� b 2�I <br /> APPLICANT:_Owner Ovmer'sAgeN �CoMractor _CONractofsAgenl _Tenant(m�s�r�c��,aeaieeerc�m�serno-ommo�+:�er�oao�w����mosc�:�l <br /> State Lic.# C�c\C �\�'� �2� City Bus. Lic.# <br /> CONTRACTOR � C � C <br /> Address <br /> �+ 12-�thT� �.fL C3e��EVue W '�' ` �b� PhonelEmail 2t�6 '76L `729 <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT �p � Cae^11� Z � <br /> } �1JU��� �+IMb(N�� <br /> ��"�eS1Ur ��I�'1� �pl� PhonelE-mail 010�Oq�L 4'la'1- C(AA'�i�° e��[ (Ol1�l'� <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK �3 S.L�Ci(�= • � <br /> �,� <br /> � y HEATSOURCE: <br /> Existing Use uf Building Q • <br /> Gas Eleclric_ Other_ <br /> Proposed Use of Building <br /> 6uilding lype: _Single Family _Duplex_Townhouse _Multi-Family _Commercial <br /> Type of project: _New _Addition _Remodel _Repair_T.I._Sign._Sprinkler_Demolition_Change of Use <br /> DESCRIPTIONOFWORK(addifionalspaceprovidedonthebacT: S�q\\ New \U�� S�S�.�'`'�. <br /> � eUC' C7'�� �1«� �.nc':. C�O� . >•r <br /> > <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type of ProJecL _New_Addn _AlteraUon_Repalr Typo of ProJect: _Now_Add.� _AlleraUon_Ropalr <br /> Show Numbcr(N)o/liztures Shaw Number(#)o(/ixtures <br /> A/C-air handling units I Toilel <br /> � Forced air syslems I Bathtub <br /> � Gas piping � Lavatory(wash basin) <br /> Water heater I Shower <br /> Gas fireplace � Kitchen sink 8 disposal <br /> � Gas range I <br /> Dishwasher <br /> � Clothes dryer Clothes washer <br /> � Range hood I Waler heater <br /> Exhaust fan ! Sin4(service/barlmop/elc.) <br /> � � � BackFlow preventer <br /> 'i Heat pump . <br /> ' Unit heater Urinal <br /> ' Drinking Fountain <br /> i Boiler I <br /> '� Rafrigeralion i Floor drain <br /> � �, Woodstove �,' Grease Vap <br /> � Duding Roof drains <br /> � Other '; Medical Gas <br /> SPRINlCLER 1 SUPPRESSiON SYSTEM I other: <br /> ' �' Olher: <br /> � � Number of Heads <br /> I hereby cenAy IP�nI I hove read and exam'.ced ihis app6cation and know the sama to be Irue and correcl.All provisions ol lmvs antl ordinances goveming this IyFa nf work will be complie7 <br /> vnth whelher speu9ed herein or not 7�e granling of a permil does nol C�esume l0 9iva aut�ority to violate or cancel Ihe provision oi any other slate or lowl law regulatinB�onsiructi� <br /> Tnat I am e fhorizetl 6y tbe owner ol this property lo pertortn Ne�vo:k for whiU appbcation Is made antl I compty wn���e Stale Contmcmrs Law 18 27 RCW anE 2962M'A'+VAC.� � <br /> �///�" ��C— 0 7 ��5I� <br /> ,{�'7 �j p � (Remsetl 3i2013) <br /> Ovmod�ulitDYjzc<t�qenl Si�nalurc <br />