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0 <br />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 />-I .-a 5_I4 <br />SITE ADDRESS: //� <br />PROPERTY TAX# <br />PERMIT <br />LEGAL for new construction Short PlaVsubilmsion lot No._ (attach copy of long legal description) <br />OWNER pJ %�` /Y /�,, <br />PhonelE-mail <br />Q <br />Address [) d2 ✓ Kc-r- <br />city/Slate/Zip <br />APPLICANT: _Owner _Owner's Agent _Contractor _ Contractor's Agent Tenant (Mutt providd droner or consent lrom coo"neno de womn the spaw) <br />CONTRACTOR yS 54WII/CF a& 4�f4lA <br />SlateeLii�c. #A,4111 F-CR1010)0 Chit Bus. Lic. # <br />Address �y > 3 /� STxJF l� UG 7A% W� 7 Phone/Ema'l <br />TENANT BUSINESS NAME <br />CONTACT FOR PERMIT <br />Phone/E.mrl �f 7 i O 8 — 7/Z' `r <br />_ <br />BUILDING PERMIT APPLICATION <br />CONTRACT PRICE -WORK, d0 <br />Existing Use of Budding _ . _ HEAT SOURCE, <br />Prer, P.d Use of Building Gas Electric_ Other <br />Building type: _ Single Family _ Duplex _Townhouse _ Multi -Family _ Commercial <br />Type of project _ New _ Addition _ Remodel _ Repair _ T.I. _ Sign _Sprinkler _Demolilion_Change of Use <br />DES RIPTION OF WORK (a�spnke�d�heeack): <br />MECHANICAL PERMIT APPLICATION <br />PLUMBING PERMIT APPLICATION <br />Type of Project: _New _Addn -_Alteration _Repair <br />Show Number (#) of fixtures <br />Typo of Project: _New _Addn _Altorallon _Repair <br />Show Number (#) of fixfures <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 />Shower <br />Gas fireplace <br />Kitchen sink & disposal <br />Gas ran a <br />Dishwasher <br />Clothes dryer <br />Clothes washer <br />Range hood <br />Water heater <br />Exhaust tan <br />Sink service/barlmoplelf; <br />Heat pum <br />Backgow prevenler <br />Unit heater <br />Urinal <br />Boiler <br />Drinkino Fountain <br />Refrigeration <br />Floordrain <br />Woodslove <br />Grease trap <br />Ducting <br />Roof drains <br />Other__ <br />Medical Gas <br />SPRINKLER I SUPPRESSION SYSTEM <br />Other <br />Number of Heads <br />Other: <br />I hereby ceaay Inal I have read and examined this application and know lee same to be true and correct. All provisions of lows and ordinances governing this type of work wig be compied <br />with whether specified herein or not. The framing of a pond does not presume to give aumonly to vielale OF cancel the provision of any other slate or Ideal law regulating consbucliun <br />Thal I am aulhaered by the owner of This property to perform the ",it fa which application is mode and I wmply wdh the Stale contractors law 1631 RC W and 296 200A WAC. <br />Ovine /Authorized Agent Signature Dale <br />(Revised 312013) <br />