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PERMIT �PPLICATION <br /> BUILDINGIMECMANICAL/PLUh!BING/SIGNISPRINKLER/OEMOLIi ION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 Cedar St., Everett, WA 98201 -425-257-8810— FAX 425•251-8857 --www.everettwa.org <br /> � ,; � j.� ��) APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> SITEADDRESS: ' � PROPERTVTAXN PERMIT# <br /> 1310 �ndu�tr �fiv2�t 2 oyo'Loo dZSo� �r, � -�' - '�<,`�` <br /> LEGAL for new constmction: Short PlaVsubdivision (�}.I �'��!�!( T �. O Lot IJo._ (attach copy of long legal description) <br /> OWNER G � � t7 � PhonelE-mail 253) 3G51- S`7 <br /> 4tldress ZOy15'7Zn� /'�� SOS'�N r7U1{G CitylStato/Zip K.C.y� V22— <br /> CONTRACTOR '�6� � � ~ L&I Lia# <br /> Ftldress Phona.�Email <br /> TENANT BUSINE55 NAME CONNA��C KF��PEntr,�T�y�y�5h .�,.% p,pv�t rA��'B 5'�'�' <br /> �Ju�.�� pC�-�SQ�/� l.d�� � ?honelE�mail � �1�� ��C� �� ��5:. <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE JF WORK '0 <br /> � �L��,t— HEATSOURCE: <br /> Exisling Use of Building 6/r-_� -- <br /> g� h�I �'i/I ��,f�A� Gas_ Eleclnc__ Othor_ <br /> Proposed Use of Building �� <br /> Buildin�type: _Single Family _Duplex_Townhous����-Family �Commercial <br /> Type of project: _New _Addilion _Remodel _Repair_T.I.�Sign_Sprinkler_Oemolilion_Change of Use <br /> Descfiption of Work(2dAifiannl spaco pravidaU an Iho bock): i', t . C r (�,���-}� �,F-�S 'n�� (,�C�'1�7 <br /> �'` i i <br /> ' ��, �-t,�'�1 �-6Ci�7G� ; rf- , �2C.�t/ � ��I ) i t��,L 1i �P r�s-h�o c�w�5 � <br /> Have you slarted working withoul a permil7 _YES�NO , � �(q� ` . � <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Typo of Projoc4 _Now_Addn __Alleralion_Repair Type of ProJecF. _New_Addn _Allertion_Repair <br /> Show Number(p)oI�xfures Show Number(pJ o!fixtures <br /> NC—air handling units Toilct <br /> Forced air syslems Balhlub <br /> Gas piping Lavalory(wash basin) <br /> Waler heatcr Shower <br /> Gas fireplace Kitcnen sink 8 dis osal <br /> Gas ranc7c Dishwasher <br /> Clolhes drycr Clothes washer <br /> Range hood Water healer <br />� Exhausl fan Sink(servicelbar/mop/etcJ <br /> Heat pump Backllow prevenler <br /> Unit healer Urinal <br /> Boiler � Drinking Fountain <br /> � Refrigeration � Floor drain <br /> Waodstove I Grease�rap <br /> Ducling I Roof drains <br /> Olher Medical Gas <br /> SPRINKLER I SUPPRESSION SYSTEM other. <br /> i Numher of HeaAs Olher: <br /> I r�ereby certily ihal I nave read and examined Ihis application a��d know lhe same lo he We and correct.All provisions ol laws antl orAinances goveming <br /> ;!n;type of work will be complied with whelher specifed herein or no�.The granling of a permit tloas nol presume to grve aulnorny to vinlale or cancel <br /> �he provision of any olher slale or local law re�uialinq co�s�mction or lhe pedormance ol ronstmction.That I am aulhcrize�by Ihe o:•:ner of U',i,propeay <br /> lo pedorm the��ro�k fc��:�h��cn appl�wtion is made antl I comply�vth the Stale Conlraclors Law 18.27 RCW and 296200 N'AC <br /> � � � Li-.� ��� ��v <br /> fiwner/Authori �g `t ' a�ure/'�, <br /> Date jRewsetl 2'2011) <br /> � � '(��-- <br />