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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 vmw.everettwa.Drg <br />r-ainuc Ai E err.PPTFn FROM R AM TO 4 PM <br />............... .,, <br />SI EADDRES <br />PROPERTY TAX # <br />PE # , ICJ 9 <br />ES <br />LEGAL for new constwclion: Short PlaVsubdivision Lot No._ (attach copy of long legal description) <br />OWNER 12 611,11 <br />Phone/E-mail <br />Address ey <br />Clty/StalelZip <br />APPLICANT:_ Owner _Owners Agent is Contractor _ Contractor's Agent _Tenant im„slFmseeaeirer orcomemr,nmme weer to ao »anmce sexel <br />CONTRACTOR 31FEll1- L. G <br />L & I Lic. # SI 81i' OD COE Bus. Lic.p# <br />Address '� '� l� F ) PhonelEmail <br />TENANT BUSINESS NAME <br />CONTACT FOF PERMIT <br />3,C Srnllh <br />L'inte (,a abty.. <br />/ <br />Phone/E.mail 5-3W-Oj24 I\D .L Oft, <br />BUILDING PERMIT APPLICATION ICONTRACT <br />PRICE OFWORK -4 rcC <br />A 1 "h HEAT SOURCE: <br />Existing Use of Building Y <br />Proposed Use of Building eALin 1, cos_ Electric_ Other. <br />Building type: _ Single Family _ Duplex _Townhouse _ Niulti-Family -�L Commercial <br />Type of project: New Addition Remodel Repair T.I. Sign Sprinkler _Demolition Change of Use <br />DESC IPTION OF WrORK (additional space provided on the¢¢ack): �JJ�,,�" �{'',. t <br />mµjyuelA r <br />I=it�n•,t Mc ru,L"J'At filu y91.4iAka )JAh,li0 vlam/�-ftfgc ,4 <br />A <br />MECHANICAL PERMIT APPLICATION <br />PLUMBING PERMIT APPLICATION <br />Type of Project: _New _Addn _Alteration _Repair <br />Type of Project: _New _Adds _Alteration _Repair <br />Show Number (#) of fixtures <br />Show Number(s) of fixtures <br />AZ -air handling units <br />Toilet -+ <br />Forced airs stems <br />Bathtub <br />Lavato (wash basin) <br />Shower <br />Gas piping <br />Water healer <br />Gas fireplace <br />Kitchen sink S disposal <br />Gas range <br />Dishwasher <br />Clothes washer <br />Water heater <br />Sink (service/bar/mop/etc.) <br />Clothes dryer <br />Range hood <br />Exhaust tan <br />Heat pump <br />Backflow preventer <br />Unit heater <br />I Urinal <br />Boiler <br />Drinking Fountain <br />Refrigeration <br />Floor drain <br />Woodstove <br />l 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 certify that I have read and examined this application and know the soma to be boa and coaect. All provisions of laws and ordinances governing In* typo of work vine be compiled <br />with whether specified herein or not. The granting of a permit does not presume to give outhonty, to violate or cancel the prevision of any other state or local law regulating construction <br />Thai I am authorized by the owner Of this property 10 perform the work for which application Is made and 1 comply win the State Contractors Law 10.27 RCIV and 299.200A %VAC. <br />q/zy 113 <br />Owner/Authorized Agent Signature Date <br />(Revised 612012) <br />`'2Z, <br />