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PERMIT APPLICATION <br />BUILDINGIMECHANICALIPLUMBINGISIGNISPRINKLER/DEMOLITION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 Cedar St., Everett, WA 98201 425-257.8810 FAX 425-257-8857 wvvw.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM R AM TO 4 PM <br />� i (, �uc�retl� <br />PROPERTY TA%/ <br />oo az- - -oo <br />P IT/ <br />- oo l <br />LEGALIor new conswtlwn. Snort Plat/suodnrsion (attach copy of bng Ngal descnpbon) <br />----_—_Pnone/E-rted <br />OWNER r I <br />Q- �% � <br />S(��s C (_'" QY D �� <br />''rr'� <br />ddress O W3D II 7Y o <br />GIyr51a1e1Zlp A <br />�/t <br />Y , r7 v-] O • f.o g l <br />APPLICANT: ✓yO,mer Owner's Agent __Contractor Conlraaor's Agent Tenantrm�cmeea eeerdmnerdrtnnmeowertodo+ortnrrc Tael <br />CONTRACTOR "(,(, S <br />L R I Lrc a L V�j COE�1Bus Lrc a 5�: Js%3 <br />a� ,--a/ <br />ddress (���D I I D II % H (] PlronerEmad as'.7 /'f- Z7L�_/ Sy+�_((' 1, <br />TENANT BUSINESS NAME <br />CONTACT FOR PERMIT haYffar�l hDmrS/� <br />Cfttcy (Zelson <br />lPhonel[rtuA <br />BUILDING PERMIT APPLICATION <br />CONTRACT PRICE OF WORK <br />Exrsling Use of Budding "` L� _ HEAT SOURCE <br />Proposed Use of Buading�1Jl1 Gas__ Electric _ Omc+_ <br />Budding fyph ✓Single Family __ Duplex _Townhouse _ Mu:II-Famlly _Commercial <br />Type of project. �( Now _ Addition __ Remodel ReDau _ T I Sign __Sprinkler Demolition Change of Use <br />DESCRIPTION OF WORK (adddrpnar span provided on mo Dacq <br />�,uJrP�'I��� <br />MECHANICAL PERMIT APPLICATION <br />PLUMBING PERMIT APPLICATION <br />TYPe of Prejec[ Mew _Addn _AMration _Repair <br />Show Number (/)ef llltlrrea <br />Type of Protect: `� New _Addn _Aheratlon _Repair <br />Show Number(f) e/flrnrref <br />NC - au handling units <br />Toilet <br />Forted arts 'toms <br />Bal hluh <br />Gas prpmg <br />Lavatory (wash hash) <br />I <br />Water healer <br />Shower <br />I <br />Gas fireplace <br />Kitchen sink 8 disposal <br />I• <br />Gas range <br />Dishwasher <br />I <br />Clothes dryer <br />Clothes washer <br />I <br />Range hood <br />Exhaust Ian <br />Sink (serv¢orharlmopfetc ) <br />Heal pump <br />Dackflow Dmvdnler <br />Unit ❑eamr <br />Unnal <br />Duller <br />Drinking Fountain <br />Reingeratlo❑ <br />Floor drain <br />Wdndslwd <br />Grease trap <br />Ducting <br />I Root grams <br />Olner <br />Medical Gas <br />SPRINKLER (SUPPRESSION SYSTED.1 <br />Omdr <br />Number of Heads <br />� Other <br />az <br />PS <br />7wf <br />�Q <br />I heteey certify draft ha: a read and exafmned dtis aprieabon and know one samo to be ne and correct Al provewns cf laws ani ord.nances governing This type of work vel be co -mood <br />with whether specked herein of not. The granting of a perms does nil prewme to gn'a aodrmsy to violate or cancel Pe pevmon of any other State or bpilaw regalnrg mmtmctwn <br />That I am arrhonad by the owner of A s popery to perform fire work ror which applcaton is made ano 1 comply wth the State Cunbactnn Law 10 .27 RC W and 296. NOA WAC. <br />31h,"e, 2111—IIZ <br />OwnerrAuthortaed Agent Signature Date (Remsed&2012) I <br />\ I� <br />SITE ADDRESS' <br />