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PERMIT APPLICATION <br /> BUILDING/MECHANICAL/PLUMBING/SIGN/SPRINKLER/DEMOLITION <br /> CIl"Y OF EVERETT PERMIT SERVICES <br /> 3200 Cedar St., Everett, WA 962G1 -425-257-88 i 0- FAX 425-257-Bb'S7-wu✓w.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM B AM TO 4 PM � <br /> PftOPERTY TAX N PERMIT C <br /> SITE ADDRESS: /�O/ U U G v y 3;y S 1- 3 L'�' L'L7 7- � <br /> !ot No._ (atta:h copy�f bng legal tlescription) <br /> LEGAL for n^w consL•uction�. ShoK Platlsubdrvision --_ ._ <br /> �� � Phpn=lE�mail <br /> OWNER I<<�E�r.it" L� Ci �2�1�����- — <br /> r.Ib�sr,e2�pF�.';l'u�.:-M'- �,J�',� ��7�SJ-c?I <br /> A6�ress���QJ r �. �' �G '�'-�1 �..__ . <br /> ., <br /> CONTRACTOR J� ti L.°.I L_a# �fR 'l�{��� 7 ��' �� - <br /> SU .�-v 2_ Ph�ne�mai a.5 'R 2-�z� <br /> Atldress .j ^� � CONTACT FOR PERMIT � <br /> TENANT BUSINESS NAME 2 U!!, �j.'�Q.��25P� <br /> �n���,�-�,,, ?�76 -b -•3Y�r <br /> BUILDING PERMIT APPLICATION CONTw+CT PRiCE oF vVORK_ <br /> HEAT SOURCE: <br /> Existing Use of Building <br /> Gas__ Eleane_ Omer___. <br /> Proposed Use of Buildin <br /> Building type: ingle Family _Duplex Townhouse�I�Aulti-Family _Commercial <br /> Type of projecC _New _Addition _Remodel �F2epair_TJ._Sign_Sprinkler_Denolition_Change of Use <br /> Description o(WorK(adJi;iona!:pace pm✓�detl on fne back�' <br /> �/ <br /> Havc you slarted working withoul a permit7 _YES �NO <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> 7ypeMProjecC _New_Addn _Alteration__Repair Typeolr'roiect _New_Addn _Alleration_ epair <br /> Show Number(tt)ol fizfu�es Show Number(t�)o(firmres <br /> NC-air handling units I Toile'�. <br /> Forced air systems I Balhtub <br /> Gas pipin3 Lavatory(wash basin) <br /> I� Waterheater I Snower <br /> � Gas fireplace � Kitclien>ink 8 disposal <br /> � Gas range � Dis'v:asher <br /> � Clothes d er � Clothes v�asner <br /> Ranae hood I Wa'.er heater <br /> Ezhaust fan Sin�(serviceloadmopletc.) <br /> Heat pumD � Barkflow areventer <br /> � Unit heater � Urinal <br /> � 6oiler I Drnkinq FouNain <br /> � Refrigera�ion � FUor drain <br /> � \Noodsteve I GreaseLap <br /> � I D�.mtinp I P.00f drains <br /> Other ___ � �Aedieal Gas <br /> SPRINKLER / SUPPRESSION SYSTEM I Jther: <br /> � N��mber of Heads <br /> � Other: <br /> I 7e�ebq ce"P>'Il;a;I have roo0 antl examinetl this appliatlon antl know Ihe sameato be true and canen.All provisions o�IaxF a7d ordi�ances govemin3 <br /> th�,s rype o'�+��A��ili be complied x+lh whelhe�specified herein o�not.The g�anlin of a pertnil does not presume to give auCu�; v���a:e o'=:+'�-^-�� <br /> Ihe prpvision o`any other sta�e ot local law regulatm�co�strudion or�he pedotmance ol constructiort Tha:I am autha¢ec by Me a.+n_:c'llus:'o�=^.>' <br /> !a p�;Ijorm Ihe work for whlch app������n is matle��d I comply with the laL^Contractors law 1827 RC'A antl 29620J N'A� <br /> % i �����;// <br /> �_ -�-- — _ ., ..� <br /> � . (,:rsca z_a� <br /> OwnerlAuihorixed A9enl Signnturc <br />