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a 2s <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 vAmeverettwa.org <br />SIT 1 <br />TAX <br />PERMIT xOPERTY , / <br />(� <br />LEGAL for new construction. Short PlaVsubdivision Lot No._ (allach copy of long legal description) <br />OWNER £� 1qdVS;AA,Ciel�L <br />Phone/E-m <br />Address - J L TIe{`�( <br />CdylSlatelZip f ft" A <br />APPLICANT: —Owner _OwnersAgent C,on�tiactor Contractors Agent _Tenant (must pmvife a a ene,of mrs,,nt earn ne o rer todo.enm ao space <br />CONTRACTOR G 7 % FiIQ- ONE /�CJC�i� <br />State Lic. # c(C KS 6/0 R4 City Bus. Lic. 4 <br />,O 0 <br />Address P. 0 0 0 2if Phone/Email, dr d/? _/L• ;y_S ryG l01) "- _ <br />TENANTRI NAME CONTACT FOR PERMIT <br />Fho�elE-0f mail Gn /t.�'7�!/ <br />BUILDING PERMIT'AfiPLICATION <br />CONTRACT PRICE OF WO <br />Existing Use of Building ___ _ _ _ HEA SOURCE. <br />Proposed Use of Building �_ Gas XElectric_ Other_ <br />Building type: _ Single Faw ly _Duplex _Townhouse _ Mulli•Family —Commercial <br />Type of project. _New -Addition _Remodel Repair _- T.I. _Sign _Sprinkle _Demolition_ Change of Use <br />tSCRIPTIONOFWORK (adddionalspace provided anthe back): f if <br />IJ�erinpU� Ci15Di'n,q rncrR/�aC� ` kf� �oC�C 4J/pew 4 SQ��rf�% if/ u/jAJae F <br />MECHANICAL PER IT APPLICATION <br />PLUMBING PERMIT APPLICATION <br />Type of Project: _New_Addn Alteration _Repair <br />Show Number (71 orfixfures <br />Type of Project: _New _Addn _Alteration _,Repair <br />Show Number(it) or fixtures <br />j A/C — air handling units <br />Toilet <br />j Forced air systems <br />I Bathtub <br />( Gas piping <br />Lavatory (wash basin) <br />Water healer <br />Shower <br />Gas fireplace <br />Kitchen sink 8 disposal <br />Gas range <br />Dishwasher <br />I Clothes dryer <br />Clothes washer <br />j Range hood <br />I Water healer <br />j Exhaust fan <br />i Sink (servicelbadmopletcJ <br />Heal pump <br />i Backflow preventer <br />Unit heater rn2dAL <br />Urinal <br />Boiler <br />I Drinking Fountain <br />Refrigeration <br />Floor drain <br />Woodslove <br />I Grease trap <br />Ducting <br />I <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 eerily that I have read and examined this application and know the same to be true and correct. All provisions of laws and ordinances governing this type of work will be complied <br />with whether speed herein or not. The granting or emit does not presume to give authority to violate or cancel the provision of any other state or local law regulating construction <br />That 1 am outs ed by)Ihe owner of this propedomt the work for which application is made and I comply with me State Contractors Law 18 27 RCW and 296200A WAC. <br />lhorized AcentS onature 4 Da (Revised Y2013) <br />