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PERMIT APPLICAI'ION <br /> QUILUING/MECHANICALIPLUMBING/SIGFv/SPRINKLER/DEMOLITION <br /> CITY QF EVERETT PERMIT SERVICES <br /> 3200 Cedar St., Everett, WA 98201 425-257-8810 FAX 425-257-8657 wwtiv.everetlwa.org <br /> APPLICATIONS ARE ACCEPTEU FROM 8 A��I TO 4 PM <br /> SITE ADDRESS: � PROPERN7A%N �7 a� I <br /> %5" /�>� �'� <br /> LEGAL lor new constmction�. Sliort PlaVsubtlivision LoI No._ (at�ach copy o��ong legal description) <br /> OWNEFt �� ��r�� �h:��L`'T� Phone�E-mail <br /> naaress S3r i!� �Avl- Cnv�SiaterziP ��;� %I liv/'�' /�C(J! <br /> APPLICANi: Owne� Owner'sAgent ,�'Coniractor Contractor'sAgent _Tenant(m�s�pm���aoa�erc.eicome����mnmeo.M=�i000rv����meepaal <br /> CONTRACTOR S:-2�lili /��'LII��'�'�-`�� 5`' �'��'%�� L&I Lic.#����'ND/��S %5 C�I�OE BUs.Lic.# <br /> r <br /> nddress /�,G —�,��� ��'� �� L`��N ���� Fhr.ne/Email LJ2JC�j� 2 �C <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT <br /> ci., �/, �,9i��UN <br /> ^- �] <br /> PhcnclE-mail �-/ "� ✓� � � 7�� <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK ' ' � <br /> Existing Use of Bulding �c".a r<<'"�� HEAT SOURCE: <br /> Proposed Use ol Building �"�����'����J Gas Glechic_ Other__ <br /> Building type: �Single Family _Duplex_Townhouse _MWti-Family _Commercial <br /> Type of projecl: New __Addi�ion Remodel _Repair_T.I._Sign_Sprinkler_Demolition Chan e of Use <br /> DESCRIPTION OF WORK(additiona�space pmv�ded on Ne backl' <br /> ,n:;i��r� ����� ,�r,���� +--1���-i`•��/�.�� �- <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Typc of ProJect: _"1ew_Addn _,AlteraUon_Repair Typc ol ProJect: _New_Addn _Allcralion_Repair <br /> Show Number(q)o(lixrores Show Numbcr(H)o(ffxfures <br /> NC—air hantlling units Toilet <br /> Forced air systems Bathtub <br /> � Gas piping � Lavatory(wash basin) <br /> Water heater Shower <br /> Gas fireplace I Kitchen sink&disposal <br /> � Gas range � Dishwasher <br /> I � Clothes dryer Clothes washer <br /> � Range hood Water heater <br /> � Exhaus�fan Sink(servicelbadmopletc.) <br /> I Heat pump � Backftow preventer <br /> Unit hea�er Utinal <br /> Boiler i Drinkin F�untain <br /> Refrigeralion I Floordram <br /> Woodstove I Grease trap <br /> Ducting I Rcof drains <br /> � Olher � Medical Gas <br /> SPRINKLER / SUPPRESSION SYSTEM Other: <br /> Number of Heads Other <br /> i i��ereLy eertM U��I haw ma�:md e�amuiea I�is opplicntion una knoei the same m Ge Ir�ie und corted.l:I Provisions of lawa an�ordinnncee B��eminp ihis rypa olwork n+tl�e mmpiled <br /> v.ah whel�er eFecifaE�erein or noL 7 Le C<i�^�inp ul n perm�l tloes nei presume lo 9v.e outton.ry io violaie or cnncel I�o pmvi:bn al eny oNer slate or local qw mpu1a11nB�onsimcbon <br /> il�ai I nm uwhonxo0 by IM1e owner ol tiiis pmpeiry lo peNerm ihe woM for which aFP�icalron n maCe antl I eompN w�n I�o Slale Conlracton Law 18 27 RCW onG 29620�A K'AC <br /> /� %i;/�./f!': L <br /> �' <br /> OwnedAu�norized Agent 519naturc Date jrc'cr.setl N20rC) <br />