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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 />SITE ADDRESS: <br />�3z <br />PROPERTY TAX d <br />PER T # <br />LEGAL for new constr rerun¢ Short Plat/subdrvrsion Lot No _ (attach Copy of long legal destnpben) <br />OWNER 03 GeMA."leII <br />Phone/E-mail6/ZS)%So—S2"i/ <br />Address J 33Z '5—. 2r10 <br />City/State2ip UIIClW E 77 7A/11 '?eZcv <br />APPLICANT:__`0wner _Owner's Agent _Contractor _ Contractors Agent Terant(must pmrmonareterof mns,,nnioaow+erto do wan in Lie space) <br />CONTRACTOR 7-a✓It, U -je ST 1(9C1 <br />Slate Lid. 14 ✓��a%r U%/fib City Bus. Lic. 4 <br />Address SI!)l SW flLo;uKA ST <br />Phone/Email 26693ZO-27 <br />TENANT BUSINESS NAME <br />/ <br />CONTACT FORPERMIT <br />Phone/E-mail '` TZ,k & Z� �y Z �'3 <br />BUILDING PERMIT APPLICATION <br />CONTRACT PRICE OF WORK 35�J <br />Existing Use of Building <br />HEAT SOURCE: <br />Proposed Use of Building Gas- Electric _ Other <br />Building type: _ Single Family _ Duplex _Townhouse _ Multi -Family _ Commercial <br />Type of projecl. New Addition Remodel Repair T.1. Sin Sprinkler Demolition Change of Use <br />DESCRIPTION OFWORK (addrfionalspace provided onthe back): Wg7f'r "r. fyTG""2 <br />Aon £Y{� i IQ?-3 7d L� r�tvnlcle r, S'r I/se& r" TZr)-IGivr tw Cs��raSf <br />pt d odr t� F ' tt� It r NFw 7Aa)'%J sM�i aFF <br />NSrM' � <br />MECHANICAL PERMIT APPLICATION <br />PLUMBING PERMIT APPLICATION <br />Typeol Project: _New_Addn —Alteration —Repair <br />Show Number (9) of rMures <br />Type of Project: _New_Addn _Alteration Y Repair <br />Show Number (0) of fixtures <br />A:C—air handling units <br />Toilet <br />Forced airs stems <br />Bathtub <br />Gas piping <br />Lavatory wash basin <br />Water heater <br />Shover <br />Gas fire lace <br />Kitchen sink 8 disposal <br />Gas range <br />Dishwasher <br />Clothes dryer <br />Clothes washer <br />Range hood <br />Water heater <br />Exhaust fan <br />Sink service/bar/mo letc I <br />Heat um <br />Backflow preventer <br />Unit healer <br />Urinal <br />Boiler <br />Drinking Fountain <br />Refrigeration <br />Floordrain <br />Woodstove <br />Grease trap <br />Ductino <br />Roof drains <br />Other <br />Medical Gas <br />SPRINKLER / SUPPRESSION SYSTEM <br />Dr1L <br />Other: )"5H'� o Vhl ✓C <br />Number of Heads <br />ONt <br />Other: 1 PfecSJM 2e rJ Ic.-1" bt <br />I hereby Unity that I have mad and ezamined rhis application and Mow the same lobe bUe and Correct. All previsions of laws and cmnari goversyng this typo of work vnll be rnmpl <br />with whether spedfied heren or nol. The granting of a peril does nor presume to give authority to violate or cancel me prevision of any other state or lowl law regulating censtiuction <br />Thal I am authorized by the owner of this property to pedor the work for which appkabon is made and I comply wire the Stale contractors Law Is 27 RCW and 296 200A WAC. <br />Owner/Authorized Agent Signature r Date (Revised 92014) <br />