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� �'t�!!�!!Y APPLICATIG�J <br /> BUILDINGIMECHANICAUPLUMBINGISIGNISPRINKLERIDEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES �..Q'7.—(/ <br /> 3200 Cedar St., Everett,WA 98201 -425-257-8810—FAX 425-257-8857—www.evereriwa.org <br /> APPLICATIONS ARE ACCEPTED FROM E AM TO 4 PM <br /> SITEADDRESS: PpOPERTYTAXN PERMI � <br /> 1 44 PF��7E FIE�D WhY Ev:.REi� WA 6.�31 <br /> LEGAL for new wnstruction: Short PlaVsubdivision�51�i57tY2 �n�pGi}�_LW No. 1� (atlach copy ol lonp lepal description) <br /> OWNER _ �z .McS NW I.LC Phone/E•mai� �`iZSJ 33° 'S62 L <br /> Address Po B�x 14�L`i City/State2ip Nl�,..�. C.,_�K WA yto:2 <br /> CONTRACTOR C_o'2 —2s � �-�oMcS N�J LLC L 8 I Lic.# C�%FZ N t H N `14l i% A <br /> C4i$ �SiY-S=LC <br /> Address PU Qu7 ���y2y (�11u �.F.'EE1C �llF 9:�J�12 Phone/Email ti�nRQ.'Cc�N�.StiN�HJ�NES,u1 <br /> TENANT BUSINESS NAME CONiACT FOR PERMIT �„�A� �r„�P��R <br /> Phone/E•mail ��'{25�33'�-$b55 M,rt;e,(,:RNEG1'�.�rH..�"nES.U$ <br /> BUILDING PERMIT APPLICATION CONTRACT PitICE OF WQRK_ <br /> Exisling Use of Building ___ HEAT SOURCE: <br /> Proposed Use of Building_______— Gas_X_ Eledric____ Other____ <br /> Building lype: X Single Family __Duplex_,Townhouse _Multi-�am�ly _Commercial <br /> Type o(project: �New __Addition �Remodel _Repair__T.I._Sign_Sprinkler__Demolition_Change of Use <br /> Desc�iplion of Work(addifional space provided on fhe back): <br /> Ba�c�� -�k ti �2 LPut� l� 9 s rs� <br /> Have you started working wilhout a permit? _YES �NO <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type ol Projecl: `/LNew_Addn ___Altentlon_Repalr Typa of ProJ�et: �N�w__ Addn __Altentlon_�R�pdr <br /> Show Number AJ of flutura� Show NumWr / ol flxtunt <br /> A/C—air handlin unils 3 Toilet <br /> Forced air s stems 2 Bathtub <br /> Gas i in Lavato wash basin <br /> Water heater Shower <br /> Gas fire lace � Kitchen sink 3 dis sal <br /> Gas ran e Dishwasher <br /> Clothes d er I Clothes washer <br /> Ran e hood Y� Water heater <br /> y Ezhaust fan Sink service/bar/mo /etc. <br /> Heat um Backflow reventer <br /> Unil healer Unnal <br /> Boiler Drinkin FouNain <br /> Retri eration Floor drain <br /> Woodstove Groase lre <br /> Ductin Roof dreins <br /> Other_____________ Medical Gas <br /> SPRINKLER/ SUPPRESSION SYSTEM other: <br /> � Number of Heads Other: <br /> I hereby certify Ihat I have read and examined lhis application and know Ihe same to be true and cortect.All provisbne of laxs and adinances goveming <br /> this lype ol woik will bc complied vnth whether specified herein a not.The granling ol a permit dces nol presume to gWa autharity to v�olate or cancel <br /> Ihe provision ol any other stale or iocal law regulating consiruction or Ihe peAormance ol construction.Thal I am authaized by the rnmer of this property <br /> lo pedorm Ihe work tor which appiicalion is made and I comply with Ihe Slale Contraclors Law 1827 RCW and 296.200 WAC � <br /> a <br /> y/?jxw �jtt.,t,A/ �+I I S I 1 l <br /> OwnerlAuthoNzad Agant Siqnalura Date (Revised 2120f i) <br />