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PERMIT APPLICATION <br />BUILDING/MECHANICAL/PLUMBING/SIGN/SPRI NKLER/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 />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />SITE ADDRESS: r <br />s <br />PROPERTTTAX# <br />PE IT 0•7 r <br />!� - J <br />LEGAL for new construction: Short Plotisubdivision Lot No _ (attach copy of long legal description) <br />OWNER C01"1 'ti <br />ifC l <br />Phone/E-mail LfLa=3\Y\b-Z399 <br />Address v -7�/�+� Cif \11 <br />city/Stahl 1!' Y T 1 r f Z.Q <br />.rt- <br />APPLICANT: _Owner _Onrer's Agent -XCcr!l3cter _ Contradors Agent Tenant lmu:rcva>a�cceror a,som rim mo o+�,crm oo.omm�o:paut <br />CONTRACTOR Oti4i,,frL (f%11d. <br />l Lic Lil. # C&h CI 3 N I COE Bus. Lic. # <br />Address `1 J uj <br />qk S1�_ it Phone)Ema,l zS-41t--L;3L <br />TENANT BUSINESS NAME <br />``I <br />Iv C\"tr <br />JCONTRACT <br />CONTACT FOR PE MIT <br />-As �� <br />Phone/E-mail <br />BUILDING PERMIT APPLICATION <br />PRICE OF WORK Ito6272ttO <br />Existing Use of Building HEAT SOURCE: <br />Proposed Use of Building Gas_ Electric_ Other_ <br />Building type. _Single Family _ Duplex_Townhouse _Multi -Family Y, Commercial <br />T e of project. _ Now Addition Remodel Repair _ T.I. Sin Sprinkler _Demolition _Change of Use <br />DESCRIPTION OF WORK (additional s1paco provided on the back)' <br />bi-Q IT((�� <br />kc) !�31- 11)ct11v� ii4�CI1C <br />MECHANICAL PERMIT APPLICATION <br />PLUMBING PERMIT APPLICATION <br />Type of Project: _New_Addn _Alteration _Repair <br />Show Number (#) of fixtures <br />Type of Project: _Now_Addn _Alteration _Repair <br />Show Number(rill) of fixtures <br />j A/C - air handling units <br />I Toilet <br />Forced airs stems <br />I Bathtub <br />! Gas piping <br />Lavatory (wash basin) <br />I Water healer <br />Shower <br />I Gas fireplace <br />Kitchen sink 8 disposal <br />Gas range <br />I Dishwasher <br />Clothes dryer <br />Clothes washer <br />Range hood <br />I Water heater <br />I Exhaust fan <br />I Sink servicelbarlmo /etc <br />Heat pump <br />I Backfiow preventer <br />Unit heater <br />I Urinal <br />I Boiler <br />Drinking Fountain <br />I Refrigeration <br />Floor drain <br />I Woodstove <br />Grease trap <br />I Ducting <br />I Roof drains <br />Other <br />Medical Gas <br />SPRINKLER / SUPPRESSION SYSTEM <br />Other. <br />Number of Heads <br />Other. <br />1 hereby wiliy, that 1 have mad and ewmined this appiiwbon and know the same to be Iwo and correct AV pmwslons of laws and orahanms goveming this type of work con be compted <br />win whether specified herein or not. The gran ling of a perms does not presume to give authority to violate orwncel tha prevision of any other stale or local law regulating construction <br />That I am aVlhudteq by the owner of this property to perform the work for which application is made and 1 campy with the State contractors Law 18.27 RCW and 298.266A WAC. <br />OwndrlAu-9 <br />l o r d Agent Signature Date (Revised 62012) <br />