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� � <br /> PERMIT APPLICATION <br /> BUILDING/MECliANICALIPLUMBING/SIGNISPRINKLER/DEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 Cedar St., Everett,WA 96201 -425-257-8810—FAX 425-257-8857—www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM E AM TO 4 PM <br /> SITEADDRESS: ��y3��72� �Z�� T� <br /> 1325 Pbc�i;c I-��e. <br /> LEGAL(or new constnction: Short PlaVsubAivisbn Lo1 No.._ (atlech ooPY���^7 bGl de�tription) <br /> OWNER �/o}wI i LLG PhondE�mai� rll� .i3g • 1'l;`� <br /> Address 'i� P :4{C CdylStete2ip �� 4 . -1��0� <br /> CONTRACTOR ��Iw+L��'f L R I Lic.it <br /> .�ddress 17 dl T ST�E st ►� vnone�mai� 360 79N � <!61 1 <br /> TENANTBU INE NAM y�f�;*f��y � H' Yr1AyGl/'2�►C <br /> /1nA2�lTLw.n 2 t� .�►..t Pnonert.mea �1 M <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK� `�1 000 <br /> EzistingUseofBuilding Cew�wun['�Q $�+-�\ HEATSOURCE: <br /> Proposed U6e of Buildir.g �t��-w�r/A�� Gas Ekctnc Other <br /> Buikling type: _Single Famity _Duplex Townhouse _Multi•Family k Commercial <br /> TypeotprojeIX: _New _Adaition _Remodel _Repair�T.�._Sign_Sprinkler_Demolition_Change otUse <br /> DesCription of Work(edditionel apece p�ovidedon the becki: <br /> Have you sfarted workinp withoul a parmR9 _YES C�NO <br /> MECNANICAL PERMIT APPLICATION PLUMdING PERMIT APPLICATION <br /> TypeolProject: _Naw_AEdn _AkenUon_Rapelr TYpaolProjacL _New_AdOn �Albntlon_Rp�ir <br /> ShowNumbar � dfirtures ShowNumbM / o�H+h�n►� <br /> AIC—airhanElin units ' ! Toilet <br /> i Forced air s slems � Bathtub <br /> I Gas i in Lavato weah basin <br /> I Water hea�er I Showef <br /> Gas fire lace ! Kitchen sink 6 0is el <br /> Gas ran ! Dishwaaher <br /> I Clotbes d er Clotl�ea was0er <br /> Ran e hood Water heater <br /> li Ezhaust fan ' Sink tenncelbadm letc. <br /> � Heat um Badcfbw reoenler <br /> i Unit heater I Urinal. <br /> I Boiler I Drinki Fountain <br /> Retri ration Floor dnin <br /> Woodstow_ ! Grease tra <br /> I <br /> Duclin Faof drains <br /> � Other �I MeAicel Gaa <br /> SPRINKLER/EUPPRESSION SYSTEM a�� <br /> � Number ot Heads � aher: <br /> 1 heieby certiy thal l heve read end e�camined this applitelwn and know the came to be true enC cortecl.NI provisions oi kw7�rM orAln.ncef povemirp <br /> this type ot xork wlll be wmplie0 wilh wfiethur speciGed harein or noL Tha prantinq of e permit dcee nW preeume to pNe�uthoiMy to videM or cencN <br /> the provision ol any other slete or loral law repulating construction w the pedormence of con6lruclan.7Tet I am aulhafaeE by 1he owner NMi�propeM <br /> to peAortn the wvrk for wfiich epplication is ma0e and 1 comply vrith the Stete Contractors Law 18.27 RCW and 298.200 WAC <br /> I , I-L�iL <br /> OwnedAulhodzeA Agent Sipn�ture Date (Revrsed YtO11J <br />