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I <br />a <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-BS57 www.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM — 1 Z <br />SITE ADDRESS: / L Oil / ,� n�19 <br />PROPERTY TA%J: <br />P n <br />#) ' <br />LEGAL for new construction: Shoo Plat/subdivisitm Lot No._ (attach copy of long legal deschphor ) <br />Address % S� <br />CilylState/Zip ll}';.2F� 1 W.4 �O <br />APPLICANT:_Owner _Owner's Agent Xcontractor _ Contractors Agent __Tenant lm,+vw°va°alene<w m°srnlrmn, me w..,ermaowm°wacel <br />CONTRACTOR F&1ik.16VDte �- y I <br />L & I Lic. If OZ?roS/Z COE Bus, Lic. 9OS9&-'S% <br />Phone/Email <br />Address s''q N- rsT 9F31 <br />TENANT BUSINESS NAME <br />CONTACT FOR PERMIT <br />Phone/E-mail <br />BUILDING PERMIT APPLICATION <br />CONTRACT PRICE OF WORK /3Us-JCniQ <br />HEAT SOURCE: <br />Existing Use of Building <br />Proposed Use of Building Ga.-IX Elecnic_ Other_ <br />Building type: _ Single Family Duplex !Townhouse _ Multi -Family _ Commercial <br />Type of project: New Addition Remodel Repair T.I. Sign Sprinkler Demolition Change of Use <br />DESCRIPTION OF WORK (additional space provided on the back): <br />pf 6-/'4L5 FaP.✓�G <br />MECHANICAL PERMIT APPLICATION <br />PLUMBING PERMIT APPLICATION <br />Type of Project: _New_Addn —Alteration —Repair <br />Type of Project: _Now_Addn __ Alteration _Repair <br />Show Number (b) of fixtures <br />Show Number (N) of fixtures <br />A/C — air handling units <br />Toilet <br />Forced airs stems <br />Bathtub <br />Gas piping <br />--Lavatory (wash basin) <br />Water heater <br />Shower <br />Gas fireplace <br />Kitchen sink & disposal - <br />Dishwasher ■ <br />Clothes washer ■ <br />Gas ra <br />Clothesan d er <br />Range hood <br />Water heater W <br />Exhaust fan <br />Sink (servicelbadmo ietc.) <br />Heat pump <br />Backflow preventer <br />Unit heater <br />Urinal <br />Boiler <br />Drinking Fountain <br />Refri eralion <br />Floor drain <br />Woodslove <br />Grease trio <br />Ducting <br />Roof drains <br />Other <br />Medical Gas <br />SPRINKLER <br />I SUPPRESSION SYSTEM <br />Other: <br />Number of Heads <br />�__ Other: <br />I hereby cenity that I have read and examined this appliralion and know the same to be hue and corned. All provisions of laws and L-dinances governing this type of work wil be oempled <br />will wbelher speed herein or not. The granting of a peril does not presume to give authority to violate or cancel the provision of any offer state or ideal law regulating construction <br />That I am au oni by er of th pro °dorm the work for whidl application is made and 1 compty wflh the Slate Contractors Law 18.27 RCW and 296.2oOA WAC. <br />O n rlAu horized Agent Signature �J Date (Revised fir2012) <br />