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.6 <br /> , <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 vww.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> SITE ADDRESS: PROPERTY TAX# PER IT. <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal desc:Ft-- <br /> OWNER —Hf '�it1"'-42-.- Phone/E-mail --= --` - <br /> Address ;°rv. -C/L —/_' City/State/Zip _/t?,,-?7 7 A- '�i;::',-'-I <br /> APPLICANT:___Owner ___Owner's Agent __Contractor Contractor's Agent ___Tenant:must pronde a;e-e,at ecn.,er•t trwn the;waer t;_:wer,,r am Space; <br /> CONTRACTOR 7 =,/ .- L&I Lic.# 1 TO L.AT'- -'',,,/,, COE B:;s__ic <br /> Address ; / _ _ /,,,-t,-- -- - ' PhcnaiEnaaii _ ^_ - <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT - <br /> -.{ <br /> , <br /> Phone/E-mail .T'_11'3 �- 4 ?'C7 ,'-�-= <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK m ., <br /> Existing Use of Building-__ _ _._ -- --- _- .-- HEAT SOURCE: i <br /> Proposed Use of Building v e:- t <br /> �' -_�� - -' -�. Gas E'=cmc_,_ C•-ger--- <br /> Building type: Single Family Duplex___Townhouse __Multi-Family _/Commerciai <br /> Type of project: New Addition __Remodel _Repair_/__T.I._--_ Sign _._Sprinkler_,__Demoiition___Charye o`Use r <br /> DESCRIPTION OF WORK(additional space provided on the back): <br /> - :- _ _ <br /> I <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type of Project: _New___Addn _ .Alteration Repair Type of Project: New-__Addn Alteration___Repair I <br /> Show Number(#)of fixtures Show Number(#)of fixtures I <br /> 1 NC-air handling units Toilet <br /> Forced air systems Bathtub <br /> Gas piping Lavatory(wash basin) <br /> I Water heater Shower <br /> Gas fireplace Kitchen sink&disposal <br /> Gas range Dishwasher <br /> i Clothes dryer Cothes washer f <br /> Range hood Water heater <br /> Exhaust fan Sink(servicelbarmopfetc.; <br /> Heat pump Backflow preventer <br /> Unit heater Urinal <br /> Boiler Drinking Fountain <br /> Refrigeration Floor Crain <br /> Woodstove Grease trap 3 <br /> Ducting Roof drains t <br /> Other Medical Gas <br /> SPRINKLER /SUPPRESSION SYSTEM - Otter <br /> Number// of Heads Other <br /> I heresy ce try ,-t t have r-.• - •:.I' ined this appiicatnn and know the same to Oe true and correct.A.,orov sons o"aws end orOirances gcveroing the Nee 01,400s wilt?ce -Pd <br /> w th a•ther s • ,v-• e ❑• . •'4.-granting of a doe - ,.g'.ve authorty to violate or cane el tl A_rovisicn o`any other stare Cr'L:a!am rr Gu o.-rg-..o -uct:c: <br /> The em• rimed t • , I tls prover. n porfn�.', appiicat•.on is made and I cor"'oiy w.h the State Contswctors Law 98.27 RCA a•-a 5f 200A WAC. <br /> -rgi -1--- - <br /> ...- j., (F.„ <br /> Owner/ horized a ent Sig .•ture / Date. _,,: 612:2'2, <br /> \4 2 <br />