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PERMIT APPLICATION <br />BUILDING/MECHANICAL/PLUM7BING/SIGN/SPRINKLER/CEMOLITION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 Cedar St., Everett, WA 98201 425-257-8810 FAX 425-257-8857 www.everettwa.org <br />SITE ADDRESS: <br />PROP ERT1l TAX <br />P�^RMITs <br />�, <br />b-QZ <br />LEGAL for new construction: Shod Plat/subdivision Lot No — (attach copy of long legal description) <br />Phone/E-mail <br />OWNER <br />/ <br />Address o 16 ir CitylstatelZip e <br />APPLICANT:_ Owner _Owner's Agent Contractor _ Contractor's Agent _Tenant(masi pnMds al eneraeereemhomthe oemria dc.mkm the spare) <br />State LLic. # /VFTLA SG Cil Bus. LiC.r# <br />CONTRACTORZN></ -' <br />1 - <br />Address %(1l03 S% e-w A IL P' JU = L C- 90 J r� i PhonelEmail LS y3Q <br />TENANT BUSINESS NAME CONTACT FOR PERMIT <br />Phone/E-mail /Z' i¢G�JK- <br />BUILDING PERMIT APPLICATION <br />CONTRACT PRICE OF WORK O� <br />HEAT SOURCE: <br />Use Building <br />Existing of <br />Gas Electric_ Ciher <br />Building <br />Proposed Use of <br />Multi -Family Commercial <br />Building type: _ Single Family _ Duplex _Townhouse _ <br />T.I. Sign Sprinkler_Demoliton_ChangeofUse <br />Type ofproject: New -Addition Remodel Repair <br />DESCRIPTION OF WORK (additional space provided on the back) : <br />MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br />Typo of Project: _Now_Addn <br />_Alteration _Repair <br />Type of Project: _Now _Addn _Alteration _Repair <br />Show <br />Numberill) or Nxtums <br />Show Number (#) of fixtures <br />A/C - air handling units <br />Toilet <br />Forced airs stems <br />Bathtub <br />Lavato (wash basin <br />Gas pi in <br />Shower <br />Water healer <br />Kitchen sink & disposal <br />Gas fireplace <br />Dishwasher <br />Gas range <br />Clothes washer <br />Clothes d let <br />Water heater <br />hood <br />Range _ <br />I Sink (servicethar/mop/etc.) <br />Exhaust fan <br />Backflow preventer <br />Heat pun D <br />Urinal <br />Unit healer <br />Drinking Fountain <br />Boiler <br />Floor drain <br />I <br />Refri eration <br />Grease trap <br />Woodstove <br />Roof drains <br />Ductin <br />Medical Gas <br />Other <br />/ SUPPRESSION SYSTEM <br />SPRINKLER <br />Other: <br />Number of Heads <br />Other: <br />I hereby candy that I have read and examined the application and know the s3 ­.e to be tma and coned. At provisions of laws and ordinances governingl this type of work will be complied <br />wdh "bather speorred henrtl or not The gaming of a permd does not presume to give authority to volute or i erRli the provision of any other sine ar local law regulatarg colMdkxl <br />That I am autno - y me owner of thi opens to perform the work for which application b made aid I compy with the slate Contractors Law 19 27 RC W and 296700A WAC. <br />OwnerIA re orized Agony Ignatu <br />Date (Revised 3/2013) <br />