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G <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 />/ ;t- —I 9-- / V <br />SITE ADDRESS: <br />PROPERTY T # <br />P RMIT K D <br />LEGAL for new construction: Short Plat/subdivision Lol No._ (allach copy of long legal description) <br />OWNER <br />Phone/E-ma <br />Mt �� Q <br />Address otolCity/Slate/Zip <br />: ,- <br />APPLICANT: Ae�<ner O�wner's Agent Contractor _ Contractor's Agent_Tenani(mvslwowaenletterorconsorllmmu,oewr riodowom nmo )ore) <br />CONTRACTOR <br />State Lic. # City Bus. Lic. # <br />Address <br />Phone/Email <br />TENANT BUSINESS NAME <br />CONTACT FOR PERW <br />PhonelE-mail Q�g•�jT�%% — MIK&OW&W <br />BUILDING PERMIT APPLICATION <br />ICONTRACT PRICE OF WORK j i <br />Existing Use of Building HEAT SOURCE. <br />Proposed Use of Building��1�V l"..�1� 1'�_ Gas_ Electric_ Other_ <br />Building type: _�Singl�e Family _ Duplex _Townhouse _ Multi -Family _ Commercial <br />Type of project: _' New _ Addition Remodel _ Repair _ T.I _ Sign -_Sprinkler _Demolilion_Change of Use _ <br />DESCRIPTION OF WORK (additional space provided oil the back): <br />1�' N��Uut�cn ei- 04, 23r X3Z' (1L c 9¢eoM SNP Mold <br />TO /36 v5c;�,lJ As A*k3 ij,, vupy F2 lfRfij I ' �tl ZEE-1sP_5 <br />MECHANICAL PERMIT APPLICATION <br />PLUMBING PERMIT APPLICATION <br />Type of Projecl: ___New _Addn _Alteration _Repair <br />how Number (#) or fixtures <br />Typo of Project: _New _Addn _Alteration _Repair <br />Show Number(N) or fixtures <br />A/C — air handling units <br />Forced air systems <br />Toilet <br />Bathtub <br />Lavatory (wash basin) <br />( Shower <br />Kitchen sink 8 disposal <br />Dishwasher <br />Clothes washer <br />Gas piping <br />I <br />Water heater <br />Gas fireplace <br />Gas range <br />Clothes dryer <br />Range hood <br />Exhaust fan <br />Water healer "z <br />Sink (servicelbarlmop/etc ) <br />Backflow preventer <br />Urinal <br />Ounking Fountain <br />Heal pump <br />Unit heater <br />Boiler <br />Refrigeration <br />Woodslove <br />Floor drain <br />Grease trap <br />Ducting <br />Roof drains <br />Other <br />Medical Gas <br />SP INKLER I SUPPRESSION SYSTEM <br />Other: <br />Number of !''ads <br />Other: <br />I hereby Idly IAal I have read and examined this application and know the same to be true and correct All provisans of laws and ordinances governing this type of wall. win be cam; ed <br />will) whether specified herein or not the granting of a permit does not presume to give authority to violate or cancel the provision of any other state or local law regulating consWeoon <br />T at I am authorized by the owner of this property to Perron the work for which application is made and 1 comply will the Slate Contractors Law 16 27 RC W and 296 200A WAC, <br />s t/7 <br />�I b- �I <br />Ow /Authorize 1 Agcut Signature DCIC (Revised 312013) <br />