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From: / 05`'"I2012 12:54 #692 P.004I004 <br /> \ l ��5�� <br /> 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–www.everethva.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO�PM �-I�� /^L. <br /> SITEADDRESS: i110Pe iAIt1 vEttMlT <br /> Z(p � fJ�.1a(''� I o�I 1 Dol�U o 5 -vZFS <br /> LEGAL for new conatruclbn: S�ort PlaVcubONialon Lot No._ (atuch copy of lanp Np�l dewlptbn) <br /> OWNER a� S�h P�onelE+�wll ZaO� 1 i /�� � <br /> dtlresa (Vi � �a�1� 11 �% ClrylStalelLlp � r.1Q yV11 �2� <br /> CONTRACTOR W Q. L 61 Llc.k IlG • W $ C <br /> tlOrssa �L�V� ,-VZ �1�1e l.� �� W �� P�one/Email ,7 <br /> TENANTBU 1 ONTACT R ERMI �ZS �3�,? <br /> �il1iG �aS . �, 1. �_ _ .C�1 <br /> Phona/E•mell G � �"�a <br /> BUILDING PHRMIT APPLICATION CONTRACT PRICE OF WORK i Z7S��— <br /> Ezisllnp Use ot BuiWinp � HEAT SOURCE: <br /> PropoeeA Use o�uildinq Oas Eloctnc Olhar <br /> Building tyDe: Sinpb Femity _Dupkz 7ownhouse _MullbFanity _Commerclal <br /> Type of project: _New _Addltion _Remodel �Repair_T.I._Sign_Sprtnkler_DemolHian_Chenpe of Uu <br /> Deserlptlon of Work(eddMbnu spar poWdsd on N»E+oW: <br /> �emo�e.� ,^c,P� QCe e1e��Y'�� wa�-e-f� �n.e��• <br /> Hava you sLrled workiny wlthout a p�rtnit? _YES _NO <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APP4ICATION <br /> Typ�ol ProJ�ct: _�Mw Addn �UbnUon_R�pdr 7yp�of Pry�tt: _N�w_Addn _All�rallon�v..p�lr <br /> SAowNumbr o/flrfun+ ShowNumbu olflrtures <br /> A/C-eirhandlln units Ta��� <br /> Foreed air s stams Bathlub <br /> � Ges i in Lavato wnh basin <br /> Wabr healer Shower <br /> Gu firo laee IOtchen sink d dfs osal <br /> Gas wn e DAhwasher <br /> Cbthes O er Clothea washer <br /> , Ren e hood Water healer <br /> Exhauet tan Slnk sarviu/Eerlmo lete. <br /> Heat um Backfbw nvenler <br /> UnN heeter Urtnal <br /> Boikr Drfnkin Fountain <br /> Refr ration Floordroln <br /> Woodslove Grease tra <br /> DuCI Roof draine <br /> � Olher i Medical Gas <br /> SPRINKLER I SUPPRESSIQN SYSTEM � aner: <br /> � Number ol Heads � Other: <br /> I haraby uNty thet I have reatl and examined INe applicaUon�nd knaw lhe same lo be Mie m0 wrrocl.N�I provlUonc ot kvn�nd or0lnances qoveming <br /> lhis type ol work vhll De comD���++���elhar sDeMed henln or not.T�a prarNnp of a permil doaa not prewms to pWe euthorYy to vroleb or c¢ncN <br /> the pmvi�ion ot any olhor�lale or Iocai law mpulalinp con�UucUon w the perlorm�nce of mnstnation.Thel I em�utliodaatl by lhe owier o1 Ws propsrry <br /> to pettorm tha woik for whlrh appliutlon h made and 1 comply wlth l�e State CoalraclOn Law 18.27 RCW and 2�8.200 WAC <br /> ,l; s 1� 12- <br /> nerlAu�harizW Ap��ri p�riur� Dale (Rsvhed?/2011) <br />