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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 wwv+.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />SITE qDDRESS' rr g.101 <br />PROPERTY TAM# <br />PE MIT# _ <br />I i1 QfG C PfC <br />LEGAL for new construction: Short Plat/subdivision Lot No._ (attach copy of long legal description) <br />OWNER EJef-eft 1 <br />' Y 7Q - <br />Phare/E-mad Z cS - 3y0 3 --11) 0 <br />q <br />Address 310 u 6 A�Q ' <br />City/State/Zip ve re 1f V\1A 9-L) t <br />PLICANT:_Ovmer _OwnersAgent ZCentractor _Contractor's Agent _TenantNTRACTOR <br />rCOAi p,'np_ ;a Pfa baxt <br />LL & I Lic. # P C q DC COE Bus. Lip. # Ile I y <br />Address !) -Jar rl CId.QO Phone/Email J/z5 - ' o - 9160 <br />TENANT BUSINESS NAME CONTACT FOR PERMIT Er; C 1�ajrta ri:l <br />E-Vereft Hou5in A-1,,ACy,$.1 Fnone/E-mail `♦l- -303--11�� <br />BUILDING PERMIT APPLICATION <br />CONTRACT PRICE OF WORK -4r900,00 each <br />Existing Use of Building_ f�eS/denl-,ki DIFielliog HEAT SOURCE: <br />Proposed Use of Building Sa m_P n s ho �/L Gas Electric Other <br />Building type: _ Single Family _ Duplex _Townhouse ✓Mulli•Family _ Commercial <br />Type of project: Z New Addition Remodel Repair T.I. Sin Sprinkler Demolition Change of Use <br />DESCRIPTION OF WORK (additional space provided on the back): Per Pro;ec+ it a013'01 ftcrrtala �Cas'b�-nPr <br />IQemol'a cu5bm°r eXj$h,1 wale S:r+i f a5 iTirnara, inStol/ rlesa! gas n RS flue, <br />`� <br />5upp)lad) -Tnc6511(a c,f-fke4I10w:nyt nrTap�l'pns)re4urn A;rfienam,5as p;Pr 91 <br />Tine Vcltpoa ) )ovi vc IloOe ) 06r4 U t-e54 ne1J <br />MECHANICAL PERMIT APPLICATION <br />PLUMBING PERMIT APPLICATION <br />Typeof Project: ✓New_Addn _Alteration_Repair <br />Typeof Project: _New_Addn _Alteration _Repair <br />Show Number (#) of fixtures <br />Show Number (#) of flxfures <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 />Kitchen sink & disposal <br />Gas fireplace <br />Gas ran a <br />Dishwasher <br />Clothes dryer - <br />Clothes washer <br />Range hood <br />Water heater <br />Exhaust fan <br />Sink service/bar/mopletc.) <br />Heat pump <br />Backflow preventer <br />Unit heater <br />Urinal <br />Boller <br />Drinking Fountain <br />Refrigeration <br />Floor drain <br />Woodstove <br />_ Grease trap - <br />Ducting <br />Roof drains <br />Other <br />Medical Gas <br />SPRINKLER / SUPPRESSION SYSTEM <br />Other: <br />Number of Heads <br />Other: <br />I hereby oedtif Net I have read and examined this application and knew No same to be Ime and coned. All provisions oflawn one"inanoes governing this type ofwork willbe complied <br />vAh whether specified hmein ornoL The granting of a permit does not pmsume to give euth, ty to violate or cancel the provision of any other stale or local law regulet6g construction <br />Thu.' em authorized by file Owner of this property to perform me work for which application is : ade and I comply cosh the State Contractors Law 18.27 RCW and 296.200A WAC. <br />, JJd4d,':2: l,nk s'/J. 6 /13 <br />Owner/Authord Agent Signature Date <br />(Revised 6/2012) <br />