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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 www.everettwa.org <br />1/1 <br />SITE ADDPROPERTY <br />76 sty �� 9ti <br />TAX h <br />PERrdIT p <br />LEGAL for new construction! Short Plat/subdivision lot No _- (attach copy of long'.egal description) <br />st�US/!} il oc/q <br />q`J�6 <br />hoe/E-m�-)-'0OWNEP�/ <br />Adtlress.-Q Q is- C/T" 1-%�{( O <br />Clty/Slate2io " f jf 104, c7AA61 <br />APPLICANT: —Owner _Owners Agent Conlractcr Conlractoes Agent _Tenant(rmn povde a.enerCwnse-t root the owner todo..cM1 n tM sp::n <br />CONTRACTOR e_ k,S1"AR. PNJ/I�UCf74,a1 <br />State Lic.# NTCKSe- 90/Re- City Bus.Lic.z <br />�'7C (11 �ty <br />Address 12c, PAC o / i 7 Phone/Email /�/dC A // c;-d2 / <br />K` <br />TENANT BUSINESS NAME <br />�[YI1Y-`/ <br />CONTACT FOR PERMIT <br />1Phone/E-maJ %\�f c1 1 <br />BUILDING PERMIT APPLICATION <br />CONTRACT PRICE OFWOR <br />Existing Use of Building _ _ _ H T SOURCE: <br />Proposed Use of Building Gas E'•ectnc_ Other_ <br />Building type: _ Single Family _ Duplex _Townhouse _ Multi -Family _ Commercal <br />Type of project: New _ Addition Remodel Repair _ T.I. Sign _Sprinkle _Demolition_Change of Use <br />SCRIPTIONOFWORK (add/Inh�onalspace provided on I rt <br />ifl[711i Cj45111n,q F u2A)'1[ 4 . h f� �! ft5� /1If6t� �f/� <br />MECHANICAL PERMIT APPLICATION <br />Type of Project: _Ncw_Addn Alteration _Repair <br />Show Number (# of fixtures <br />PLUMBING PERMIT APPLICATION <br />Type of Project: _New—Addn _Alleratlon_Repair <br />Show Number (:) of fixtures <br />A/C - air handling units <br />I Toilet <br />I Forced air systems <br />I Bathtub <br />I Gas piping <br />I Lavatory (wash basin) <br />Water heater <br />! Shower <br />! Gas fireplace <br />I Kitchen sink 8 disposal <br />! Gas range <br />! Dishwasher <br />I Clothes dryer <br />Clothes washer <br />Range hood <br />Water heater <br />! Exhaust ran <br />! Sink (servicelbar/mop/etc ) <br />! Heal pump <br />I Backflow preventer <br />a I Unit hea <br />Urinal <br />I Boiler <br />1 Drinking Fountain <br />I Refrigeration <br />I Floor drain <br />! Wbodstove <br />I Grease trap <br />Ducting <br />f Roof drains <br />Other <br />! Medical Gas <br />SPRINKLER / SUPPRESSION SYSTEM <br />! Other: <br />Number of Heads <br />i Other. <br />1 hereby ceAdy thal I have read and exami:ted this application and know Ike same lobe true and correct. All provisions of laws and ordinances governing INS type of work will be complied <br />wdh whether Sped heiem or not, the granting of ertnit dtts Oat presume to give authority to violate or cancel the provision of any other stale or local law regulating conswction <br />That I am arulh ed by the owner of this pro ped dams Ihework lur whim apptcation is made and I comply with the Slate Contractors law I 27 RCW and 296 200A WAC. <br />2 ` ��% ( i <br />OwncHisulhori:ed Agent Signature Da / (Revised 3,2073) <br />