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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—veww.everettwa.urg ✓I,l <br />trONS Aoc ArrFRTFn FROM R AM TO 4 PM (J �-% <br />RMI a <br />SITE ADDR, SS: ,D0 Gi�r� Ave <br />� <br />PROPERTY TAke <br />LEGAL fix coonstruction: Short Platisubithrmlon Lot No._ (attach copy or long legal description) <br />//►�nejw, <br />44rkAAN5 Phone/E-mail <br />OWNER/'/fJ.-r-(af\) <br />�{ <br />� \r F\ZA-f� " ` =JP - I <br />ddress p?{p��. r.vt�n V - City/state/zip <br />GL&TT FS k 92-2 �! <br />CONTRACTOR ��-- S�KT Z' L 8 I Lic. 0 <br />c'`�, 2- aS3 73(o-S33y <br />Address T.� S% �� �it�tJ uiQ. PnixblEmail <br />TENANT BUSINESS NAME <br />FOR PERMIT f, O'Mi � A� <br />-F�/�BUILDING <br />LONTACT <br />all ,I";z <br />PERMIT APPLICATION <br />CT PRICE OF WORK <br />�-r` f!EAT SOURCE: <br />Existing Use of Building _ <br />Proposed Use of Building 2k Gas Elednc Other <br />Building type: Single Family _ Duplex_Townhouse _Mufti -Family _-Commercial _ <br />Type of project: _New _ PAdition —Remodel _ Repai� T.I. _Sign _Sprinkler _Demolitlon_Chenge of Use <br />Description of Work (additional spare provided on the back): r& 1G r. s/�yN(r•1fL "7i7 $*Ir-40�— <br />Have you started working without ■ permit? _YES NO <br />MECHANICAL PERMIT APPLICATION <br />PLUMBING PERMIT APPLICATION <br />Type of Project: _Addn _Alteration _Repair <br />Type of Project: _New _Addn _Ableratlon,_Repair <br />_Naw <br />Show Number o! flstuns <br />Snow Number of Rxfms <br />A/C - airhandlin units <br />Toilet <br />Forced airs stems <br />Bathtub <br />Gas i <br />Lavatorywash basin <br />Water beater <br />ra <br />Shower <br />Kitchen sink 6 disposal <br />Gas fireplace <br />Dishwasher <br />Gas ran a <br />Clothes d er <br />Clotheswasher <br />Range hood <br />Water heater <br />Exhaust fan <br />Sink servicelbar/mo /etc. <br />Heat pump <br />Backnow preventer <br />Unit heater <br />Urinal <br />Drinking Fountain <br />Bolter <br />Refrigeration <br />Floor drain <br />W'oodstove <br />Grease trap <br />Ducting <br />Roof drains <br />Other <br />Medical Gas <br />SPRINKLER I SUPPRESSION SYSTEM <br />Other: <br />Number of Heads <br />Other: <br />I hereby certify that I have read and examined this application and know the same to be true and correct. All previsions of laws and ordinances governing <br />this type of work will be complied with whether specified herein or not. The granting of a permit does rwt presume to give auarority to violate or cancel <br />the provisio- of any other state or local low regulalir- -xmstruction or the performance of construction. That I am authorized by the owner of this property <br />to perform the h application is made aid I Limply with the State Contractors Law 18.27 RCW and 29e.200 WAG <br />OwnerlA rized Agent Signature Date (Revised V20f1) <br />