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PURN-J' APPUCATION <br />t31)II.I)INGINIECAIAi4IGAI_/PLUMBING/SIGN/ST RINK)_ER/IJf_I 01.1110N <br />CITY OF EVERETT PERMIT SERVICES <br />3200 Cedar St., Everett, WA 98201 425-257-8810 FAX 425-257-8857 www.everettwa.org <br />4 ,-Z Q--1 57 <br />SITE ADDRESS: PROPERTYTAXN D %� MT' j <br />j U 0'� 3�oC SE �yQroff,W <br />LEGAL for new construction: ShortPladsubdivislon Lol No._ (attach copy of long legal description) <br />OWNER 5�7`/'-.o ��S.9f1 EPhonel&n , j{��u�3 MAr .C <br />I daG4 9 <br />nderess /� a.. 17� S G t <br />APPLICANT:_ Owner _Owners Agent _Contractor XContraclofs Agent ,Tenant fmasl p,z.�roknermm�mmfrem ma oh+:rwap wvANthe spr_e> <br />Slate LIc. # /� 5 �2 City Bus.. Lie. <br />CONTRACTOR : <br />/l��/� / <br />� ,(,r / j� ff <br />redress�J /2- ��lNyz � � �-��f � Phone/[mall ]-3 -/�./ Clls�-1v��7ov7..�' <br />,111 <br />TMTAN7=ESS NAME CONTACT FOR PERMIT <br />Phone/E-mall {� i �"c'S' •�--�'"' <br />BUILDING PERMIT APPLICATION <br />CONTRACT PRICE OFWOR // <br />Existing Use of Building HEAT SOURCE: <br />Proposed Use of Buildind2r—Gas__- Electdc__ Other_ <br />Building type:' Single Family _ Duplex _Townhouse _ MuN-Family _ Commercial <br />Type of project: _ New _Addition _ Remodel _ Repair T.I. _ Sign _Sprinkler _ Demolition_Change of Use <br />DESCRIPTION caD+ovldedonfhcbark): <br />RMIT APPLICATION <br />MECHANICAL PERMIT All PLUM;;n <br />Typeof Project: <br />—.Alteration —Repair <br />Type of Project: __Add <br />_Alteration_Repair <br />•_New_,Addn <br />Show <br />Number (#) of !ufunim <br />Sh) <br />of fixturesA/C <br />— air handfing units <br />Forced air systems <br />ubGas <br />(wash basin) <br />pi ingory <br />Shower <br />Water heater <br />KilCh'in sink & disposal <br />Dishwasher <br />Gas fireplace <br />Gas range <br />Clothes drver <br />Clothes washer <br />hood <br />Range hood <br />- <br />Water heater <br />Sink (service/bar/mop/etc.) <br />ExhbuBackllow <br />reventer (Inside bid ) <br />Healum <br />Urinal <br />Unit heater <br />. <br />Odnking Fountain <br />Boller <br />Refrigeration <br />Floor drain <br />Woodstove <br />Grease tm <br />Ducting <br />Roof drains <br />----- <br />—Other <br />Medical Gas <br />SPRINKLER / SUPPRESSION SYSTEM <br />Other. <br />Number of Heads <br />Other <br />I hemby ceNly that I have read and examined this application and know ilia same to be wa and coned. AN plovisb'a of laws and ordinanees gmeming this type ar work wm be COMP <br />wide whether speed herein or not. The granting of a permit does not presume to gNa aulhonty to violate or cancel the prevision of any other state or local law regulating conslmcllon <br />That I am authorized by the mnor of this Property to perform the work for which appi carton Is made and I comply with the Slate contractors Love te.77 RCW and 296200A WAC. <br />(Revised 42015) <br />Owner Authorized Agent Signalurt✓ Date <br />