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c I <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 www.everettwa.org <br />APPI lr.AT1nNS ARE ACCEPTED FROM S AM TO 4 PM 7 —1 6) —( Z <br />•'. - --- ------ <br />SITE ADDRESS: '1 <br />%�O t 11r11[3M <br />PROPERTY TAX N <br />L o 11 oo I O) too <br />MIT i <br />LEGAL for new construction: Short Plat/subdivision Lot No._ (attach copy of long iegal description) <br />OWNER Sr`11106 nsrn C fITIM <br />Phone/E-mail <br />Address -71o0 l�F�dah ii.i <br />City/Stale/Zip �vearjt :vtk Vlo'b <br />APPLICANT: _Owner _Owner'sAgent ,Contractor Agent _Tenant lm,rstprevioe bnaracon:om lydn me o«rertoawaxnme spiel <br />_Contractors <br />CONTRACTOR �W l"'rA}.�� TNT <br />L & I Lie. # Wa1.FE�Q1 COE Buss. Lie. # <br />'iO�TC <br />Address ll 51 � 1 C rl JE d <br />V�i��� <br />WA 91r17 L Phone/Email <br />TENANT NAME ` <br />WWIrN VN�y'T""f ��1a1raf7�l.t r,7MIIwNlr1 <br />J <br />CONTACT FOR /PERMIT <br />'f <br />Phone/E.mail 36o-rt'1r41- v <br />BUILDING P1ERMIT APPLICATION <br />CONTRACT PRICE OF WORK <br />Existing Use of Building HEAT SOURCE: <br />Proposed Use of Building Gas Electric Other <br />Building type: _ Single Family _ Duplex _Townhouse _ Multi -Family Commercial <br />Type of project: New Addition Remodel Repair T.I. Sin Sprinkler Demolition Change of Use <br />DESCRIPTION OF WORK (additional space provided on the back) : <br />AJ4 t JtA.,Klers 4nd VMVC L elks -I. rlC4, w•ll is Ift4l <br />1 M Pe."ewleRl. <br />MECHANICAL PERMIT APPLICATION <br />PLUMBING PERMIT APPLICATION <br />Type of Project: _New _Addn _Alteration _Repair <br />Show Number(N) of Nxtures <br />Type of Project: _New _Addn _Alteration _Repair <br />Show Number # offxtunes <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 />Gas range <br />Dishwasher <br />Clothes dryer <br />Clothes washer <br />Range hood <br />Water heater <br />Exhaust fan <br />Sink service/barlmo letc. <br />Heat pump <br />Backilow, preventer <br />Urinal <br />Unit heater <br />Boiler <br />Drinking Fountain <br />Refrigeration <br />Floor drain <br />Woodstove <br />_ <br />Grease trio <br />Ducting <br />Roof drains <br />Other <br />SPRINKLER I SUPPRESSION SYSTEM <br />Medical Gas <br />Other: <br />Other: <br />Number of Heads <br />I hereby ceddy that I have read and examined this appl"tlon and know the same to be true and coned. All provisions of laws and ordinances goveming this type of work will be complied <br />with whether speed herein or not. The granting of a permit does not presume to give authority to violate or cancer the provision of any other state or local law regulating constriction <br />That I am authonzed by the owner of this property to perform the work for which application is made and I comply with the State Conlredors Law 18.27 RC W and 296.200A WAC. <br />caner/Authorized Agent Signature D e <br />(Revised &2012) <br />