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Y <br /> r Pc <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.everetma.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> SITE ADDRESS: _ _ PROPERTY TAX#- ,.EOC6022CO, OC4',i3OC60010 PE MIT <br /> ,t -10,6 IOo [ oi 03 <br /> LEGAL for new construction: Short PlaUsubdivisionLot No. (attach copy of tong legal desc ct'-r <br /> OWNER /�,-o - Phone/E-mail -_ '- ', <br /> Address .. -/_ City/State/Zip =/"- ,- j)':-.: <br /> APPLICANT: Owner -Owner's Agent Contractor Contractor's Agent _- Tenant•rust_mane a:e-.a or censers from vie:w-er t,__tvcr,r tie rcncc; <br /> CONTRACTOR _ =L-_-- , - L&I Lic.# 7=_ , ,I ,J.- -\,,,',1- COE Bus._Ic.R <br /> ?Ilene/Email _ -- . -•', ,. <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT _r-.3.-. <br /> K \,,-, <br /> /_.-tT-1 Phone/E-mail <br /> I <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK <br /> Existing Use of Building _ -._ y ___ _ _ _- HEAT SOURCE: i <br /> Proposed Use of Building G,0 -- :== 3 -- Gas Eectric____ Oh'er_ I <br /> Building type: ___.Single Family ___Duplex___Townhouse Multi-Family _�Commercial <br /> Type of project: New Addition ___Remodel __Repair_/ T.I. Sign __Sprinkler___Demoiltion___Cnange of Use f <br /> DESCRIPTION OF WORK(additronai space provided on the back): <br /> - - .-- _ - - - - • '•G `IE7 C.:L C INtC \0 EX 7 EhIOR r.GRK MODIFICATIONS OF ' --N ORS TO INCLUDE <br /> -- _ NUR NCA INCR.: -•" \O _ _ _ �_5, CASEINCRK. _ '2r-^U OF NE:. 1 <br /> - -: _ ',xi:, :_-;NS - __ :.•-_, -E -_ =_.MBING SYSTEMS °c =-'E'Y r <br /> I <br /> - F.F-1 EF S:1=FTY cr.-F,-. TM R= if'.-:FR C=51 -C hT ',FFCRRE:. 4,,E'••.•- <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION I <br /> Type of Project: ___New___Adds __ _Alteration Repair Type of Project: __New_ Addn ___Alteration__Repair t <br /> Show Number(#)of fixtures Show Number(Ii)of fixtures } <br /> A/C-air handling units Toilet <br /> Forced air systems Bathtub <br /> GasPin iP g Lavatory(wash basin) <br /> Water heater Shower <br /> Gas fireplace Kitchen sink&disposal <br /> Gas range Dishwasher 1 <br /> Clothes dryer Clothes washer <br /> Range hood Water heater I <br /> Exhaust fan S±nk(servtceloar;mopfetc <br /> Heat pump Beddow preverter <br /> Unit heater Unnna1 <br /> Boiler Drinking Fountain <br /> Refrigeration • Floor drain t <br /> Woodstove Grease trap f <br /> Ducting Roof drains <br /> Other _ - _ Med:cai Gas I <br /> SPRINKLER I SUPPRESSION SYSTEM Other: <br /> r <br /> Number of Heads Other: .• <br /> i heresy certify that t have read ark-. •mined lhs apolicalion and know the same to be true and correct.A i provisions of taws end ordinances gcverning 51$we in war4;inkbe cen,;;-i9 <br /> with whether see .• d herein....,0"ow <br /> Inn.f. ..es not presume to eve authorty to violate or lancet 4!•e provision of any other state ,r Inst aa':Fir i o'% ucfcr <br /> Thal tam. dried .- r 3,,..._:•_.. .. lication is trade and I cor^siy wan in State Contac!ors Law te.2r i-lc.Y.ai•d_b..:MIA'f::C. <br /> if <br /> ' _.60,-rie--- , <br /> alIgigg:(1 -- • /s.1 r,. ' <br /> Owner/Authorized Agent S 3 nature late. _,,sec:d <br /> � <br /> 1 <br /> � <br />