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9 S <br />PERMIT APPLICATION <br />BUILDING/MECHANICAL/PLUMBING/SIGN/SPRINKLER/DEMOLITION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 Cedar St., Everett, WA 98201 425-257-8810 FAX 425-257-8857 mAwaverettwa.org <br />SITE �RE�S: _ _ r ems^/ <br />�.Qy(''17 O`El <br />PROPERTY TAX p <br />P <br />fill # <br />LEGAL for new construction Short Plat/subdnns,on Lal No._ (attach copy of long legal description) <br />OWNEf2' IVOU_SlAp, Vic Oeij <br />Phone/E.m I �S Q08 <br />Address �L Ti24E'r <br />C.tylStale/Zip f j f ikA. <br />APPLICANT: —Owner —OwnersAgent Contractor Conbaclors Agenl _Tenant fmmtpmneea lenerolununit-omtheownenodowom At" space) <br />CONTRACTOR L S%�. ON5 /i�UL(—ids <br />Slate Lic. # QCKS 6 City Rus. Lic. # <br />^ I ,0 if <br />Address 1 • n tJ - Phone/Email /�dL 42/ram 5% UG rOJ <br />TENANT BUSINESS NAME f <br />o,eif <br />CONTACT FOR PERMIT <br />Q,K O <br />Phone/E-mail � /IMF./ <br />BUILDING PERM ITk PLICATION <br />CONTRACT PRICE OF WO <br />Existing Use of Building <br />HEAT SOURCE: <br />Proposed Use of Building _ <br />Gas Electric_ Otherit <br />Building type: _ S'.ngle Family _Duplex _Townhouse _ Multi -Family _Commercial <br />Type of project: _ New _ Addition _ Remodel _ Repair _ T.t. _ Sign _Sprinkle _Demolition_ Change of Use <br />SCRIPTION OF WORKfadddionalspaceprovidedontheback) it /t <br />�inpUf �jCi'sP)i�q �tr2,JaC� Rf�%[4/pubJ4 SG���f� �l£rJ �v/IAJacP� <br />C�P7jER <br />MECHANICAL IT APPLICATION <br />PLUMBING PERMIT APPLICATION <br />Type of Project: _New _Addn Alteration _Repair <br />Show Number (# of fixfures <br />Typo of Project: _New _Addn _Alteration _Repair <br />Show Number (#) of fixtures <br />A/C — air handling units <br />Toilet <br />I Forced air systems <br />I Bathtub <br />Gas piping <br />I Lavatory (wash basin) <br />Water healer <br />I Shower <br />Gas fireplace <br />Kitchen sink & disposal _ <br />I Gas range <br />Dishwasher <br />I Clothes dryer <br />I Clothes washer _ <br />Range hood <br />Water heater <br />Exhaust Ian <br />I Sink (service/bar/mop/etc.) <br />I <br />Heat pump <br />I Backflow preventer <br />I <br />Unit heater la 2n/AC <br />I Urinal <br />j <br />Boiler <br />_ <br />I <br />Drinking Fountain <br />Refrigeration <br />Floor drain <br />Woodstove <br />I <br />Grease trap <br />Ducting <br />I <br />Roof drains <br />Other <br />Medical Gas <br />SPRINKLER / SUPPRESSION SYSTEM <br />I <br />Other: <br />Number of Heads <br />Other: <br />I hereby certify that I have read and examined this appllwlion and know the same to be true and correct. All provisions of laws and ominannes governing this type of work will be complied <br />with weather specific herein or not. The granting ofa/p ennn does not presume to give authomy to violate or cancel the provision of any amet state of local law regulating construction <br />Thal i am auth ed bwthe owner of this propel LL44Cdonn the work rot which application is made and I comply win the Slate Contractors Law 16.2? RCW and 296.200A WAC. <br />Y1>r I <br />9 tok- <br />(Revised Y20f3) <br />Owner/Authorized AoentS dnatu Da <br />