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PERMIT APPLICATION <br />BUILDINGIMECHANICAL/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 everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM / d6`r q <br />SITE ADDRESS: <br />[Pt-2-MA1JL�:,Y LAME <br />PROPERTY TAX** <br />oo384bcgt33ott+oo <br />1 PE Mtrif _oO� <br />C <br />LEGAL to, ^ew construction Shod PlaUsubd vSan Lot No. (attach copy of long legal descnplion) <br />OWNER Z b M r.Gq STbrJeLti�hE(i. <br />PnanelE-mail OB•Q t'1 ^I O iJ <br />Address 1 L F <br />CitylSlaletZip Cv(Pl r 4ClA <br />APPLICANT: _Ow e.r XOwners Agent _ _Contractor _ Contractors Agent _Tenant lmua po•ideaianm ar mnssm hem ue ovmeno dp+oamue span„ <br />CONTRACTOR lill E�—,I.J U ILD <br />L 81 Lic. d Ati EG>im 2,'5Pnl COE Bus. Lic N f061063'1 <br />Add,,,-, ' (UOD MAI.I.I0hF:;OCA XVE- I'J• Sea Tf LelMA--1Alb3 Phouelfma'd 20U • ii LIL41- <br />TENANT BUSINESS NAME <br />CONTACT FOR PERMIT i,_A t kj�4 uCnU •(En! <br />MNcuYcN e,lnsoEuldvlaul <br />PhoaPIE-mail 1bul. 2 i <br />BUILDING PERMIT APPLICATION <br />CONTRACT PRICE OF WORK 4Li lH •I� <br />Existing Use of Building �(, S t nth Lr�/ C4 hn l V`(� HEAT SOURCE: <br />Proposed Use of Building load L,.4A T (. CStrv[T _ A/ -►MIL Gas_ EleclncOther__ _ <br />Budding types )L Single Family _ Duplex _Townhouse _ Multi -Family _ Car lmercial <br />Type of project New Addition Remodel Repair T.I. Sign Sprinkler Demolition Change of Use <br />DESCRIPTION OF WORK (additional space provided on the back) <br />ln4'1e2t0R- gawochpt,- a: -F-yISTfIJC AMH-Y PVAfJ <br />MECHANICAL PERMIT APPLICATION <br />PLUMBING PERMIT APPLICATION <br />Type of Project: _New _Addn Altnration _Repair <br />Shaw Number II) or fixtures <br />Type of Project _Now _Addn XAlteration _Repair <br />Show Number (0) or rrxfures <br />A/C - air handling units <br />I <br />Toilet <br />Forced airs stems <br />t <br />Bathtub <br />Gas piping <br />Lavatory wash basin <br />m <br />Water healer <br />Shower <br />e <br />Gas fireplace <br />1 <br />Kitchen sink & disposal <br />Gas range <br />1 <br />Dishwasher <br />Clothes dryer <br />1 <br />Clothes washer <br />Range hood <br />p <br />Water heater <br />_ <br />Exhaust fan <br />I <br />Sink semicelbarlmo /etc <br />Heat pump <br />Backllow preventer <br />Uml heater <br />Urinal <br />Boiler <br />Dnnking Fountain <br />1 <br />Retrl eration <br />floor drain <br />WDedslove <br />Grease trap <br />MIL <br />Ducting <br />Roof drains <br />Other _ <br />(7 <br />Medical Gas <br />SPRINKLER I SUPPRESSION SYSTEM <br />Other. <br />91 <br />Number of Heads <br />Other: <br />I hereby comfy that 1 have mad and examined this appl,eatian and know the same to be we and correct. All provisions of laws and ordinances goveming In is type of walk will be complied <br />with whether spacbed herein or not. no granting of a pennil does not presume to give authority to violate or cancel Me provision of any other state or local taw regulating Wnsbllcban <br />That I am uthonzod by the owner of this prepudy to Panora the work lot which application is made and I cam pay with the Slate Contradms Law 16 21 RCW and 296.200A WAC. <br />Owned u orlred Agent all <br />Datn (Revised N2012) <br />1 <br />4 <br />