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PERMIT APPLICATION <br />BUILDING/MECHANICALIPLUMBINGISIGN/SPRINKLER/DEMOLITION <br />CITY CIF 'aVERETT PERMIT SERVICES <br />3200 Cedar St., Everett, WA 98201 425-257.8810 FAX 425-257-8857 www.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM S AM TO 4 PM <br />SITE ADDRESS:. A <br />PROPF g TAX It 50I O (] <br />LEGAL for new construction Shan i latlsubdNisu n Lot No (attach copy of long legal description) <br />OWNER <br />fZjY <br />G <br />PhonelE+ d 4,2 J5 - �j�q -1/ 2g61 <br />ddress�L030 <br />, <br />II .T: 25D <br />77 <br />Gty)Slalejz,p ww '.f-DO o <br />APPUCANT:_Qrmi, Ownnr's Agem Coulraclor Contractor's Agent Tenant tmm prerbeakterdrorted item Creorerto da won nite soael <br />CONTRACTOR fiA <br />j <br />L A I Uc AtQ L d3 _ Bus Lic o 05 -73 <br />/C rOE <br />1��-�, QonefEmA I a✓55-��i- 2i4` <br />Address � o htf/ I - 5o 8j Ph <br />TENANT BUSINESS NAME <br />CONTACTFOR PERMIT <br />s1u 12clson -S-7q-2z�{ 4 <br />PhoneJE d C , p' <br />BUILDING PERMIT APPLICATION <br />ICONTRACT PRICE OF WORK zIb/ FDQD <br />Existing Use of Building !�It E����� _ rv1 HEAT SOURCE <br />Proposed Use of Buildingd_t L ��2.� fJ—�S Gas___ Electric__ Other___ <br />Building typo Single Family _ DupkL! x —Townhouse _ Multi Family __ Commercial <br />Type of ptolect. _New Addition Remodel _ Repau _ T I _Sign Sprinkler 4Demo lition_Change of Use <br />DESCRIPTION OF WORK (additional space proved on the baelq <br />(emo ep� sfoc-brie . etoid new tgrnyte -fa#tlly /InAlli top <br />house t- ohop louse = <br />MECHANICAL PERMIT APPLICATION <br />PLUMBING PERMIT APPLICATION <br />Type of Pro)ect _Few _Addn _Aheraeon _Repair <br />Show Number (e) of Rabaref <br />Type of Prefect: _New _Addn _Ahwatlon _Repair <br />Show Number (•) of Raolree <br />AJC - au landlin units <br />Todel -a" <br />Forced ee Systems <br />Bathtub <br />Gas piping <br />Lavatory (wash basin) <br />Water heater <br />Shower <br />Gas fireplace <br />Kitchen sink A disposal <br />Gas range <br />Dishwasher <br />Clothes dryer <br />Range hood <br />Clothes washer <br />Water heater <br />Exhaust fan <br />Sink (serWcolbarJmopfelc ) <br />Heat pump <br />Bacleflow preventer <br />Unit heater <br />Boiler <br />Unnal <br />Drinking Iiountain <br />Refrigeration <br />Floordram <br />Woalstwe <br />Grease Ira <br />Ducttreq <br />Roof drams <br />Medical Gas <br />SPRINKLER /SUPPRESSION SYSTEM <br />Other <br />Number of Heads <br />Other <br />I hereby certify teal I haf read and examined this application and know lie same to be the and correct Al pmr6tons of laws and ordinances goxemmg this lyre d work wel be comped <br />wth whether specified hereinor not. The granDng of a permit does nor presume to gwe authorty N inoote ar Cancel the pwsion of any other sure or but law tegulalng mnstmcton <br />That I am aNhonad bythe owner of th6 popedy b perform the work for which appfcaton is crude and I comply with the Stale Corti Law 18 77 RC W and P9G 2OOA WAC. <br />OwnerfAuthorrxed Agent Signature Date (Resesed&?011) <br />I Za <br />