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PEaMIT APPLICATION <br /> BUILDINGIMECHANICALIPLUMBING/SIGN/SPRINKLER/DEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 Cedar St., Everett, WA 98201 425-257-8810 FAX 425-257-8857 ww�v.everetlwa.org <br /> SITE�DRESS: u L PROPERTY TAx p PERMIT�n . _ <br /> LEGAL lor new construction: Shotl Plallsubdivision Lot No._ (attach copy ol long legal description) <br /> OWNER r f ) PhonetE-mail y�s 9� S <br /> Adtlress �QQ y M ,L `L CitylSlateiZip <br /> APPLICANT: Owner Owner'sAgenl ��ontractor Contractor'sAgent _TenaN�m�sip�oroaamnoroiwosemnomuwo..Mnoao�or�-mespa�el <br /> CONTRACTOR L c Slate Lic. #� O /� Cit Bus. Lic.# <br /> Address �6 U� /� � p/ Q Phone/Email <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT <br /> PhonelE-mail �,: _ <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE �• �i'.r'tti V _ <br /> Existing Use of Building�l� ' //.4� !J(il7�msA p�ol. HEAT SOURCE: <br /> Proposed Use of Building�ir �B �� �L S/Ph Gas__ Eicctric_ Other_ <br /> Building type: f/Single Family ,_Duplex_Townhouse _Mulli•Family _Commercial <br /> Type of project: G New _Addition _Remodel _Re,,air T.1._Sign_Sprinkler_Demolition_Change of Use <br /> DESCRIPTION OF WORK(addi6onal space provided on the 6ack): <br /> lNli a� �¢S'2"l.l'= -Ca/�TMb-F�tb h�%- �B R�T1/•aG� °�I SLy13 <br /> (�1' Pao� rq-rz�z�4 - -��Ag �'X�fn�G <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Typo of ProJocl: _Now_Addn _Alteration_Repalr Typo ot Projoct: _Now_Addn _Attora:lon_Ropalr <br /> Show Number(d)o/fixtums Show Number(p)o//lxfures <br /> A/C—air handling units I Toilet <br /> � Forced air systems BatMub <br /> Gas piping I Lavatory(wash basin) <br /> Water healer Shower <br /> Gas fmplace � Kitchen sink&disposal <br /> Gas range I Dishwasher <br /> � Clothes dryer i Clolhes washer <br /> Range hood I Water heater <br /> Exhausl(an � Sink(service/bar/mop/etc.) <br /> Heat pump I Backflow preventer <br /> � Uni�healer I Urinal <br /> ! Bo;ler I Drinking Fountain <br /> � Re(rigeralion � Floor drein <br /> Woodslove II Grease trap <br /> Ducting I Root drains <br /> � Other �, Medical Gas <br /> SPRINXLER / SUPPRESSION SYSTEM 1 Othec <br /> NumherofHeads �I Other: <br /> I here6y ce�Ay Ihat I havo read enC eeamwed th�s apphcation and know t�e samo l0 6e Ime nnd mned.All provisions ol laws entl oM�rances goveming t�is typo ol wod�nit bo complied <br /> wlth whei�er specdieG nerein or nal.TTe 9ranting ol a pertnd Coes not Dresume lo give autnortly to vroiale or wncel Ine pmvision ol any otber state or lowl law regulatin�cwslmction <br /> T�et I em authorized by t�e owner ol t�is pmperty io peAortn t�a work lor xhich appiicaUon Is matle an01 comply with tne Stele Ccnracton Law 1B.P7 RC\Nand 2?62COA WAC. <br /> �/1 L lr ���''�� I <br /> OwnurlAuthorizod Agont Signaturu Date (Revised 3/2073J <br />