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L <br />PERMIT APPLICATION <br />BUILDING/MECHANICAL/PLUMBING/SIGN/SPRINKLER/DEMOLITION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 Cedar SI , Everett, WA 98201 •125-257-8810 FAX 425.257-8857 www everettwa.org <br />SITE ADDRESS: <br />41oA t, (IV � <br />Pa DpLa `y TAX a 0o DD <br />a <br />PE II <br />LEGAL'cr BEN c((e''r��slruhlan\ Short PlaVsubdivlston Lot NO (allach copy of long legal descopbon) <br />OWNER <br />1 <br />`+ V- �h <br />VIA <br />I__ <br />Phone/E mar1 T25,� (b Vn*%b'r .coin <br />Address �l1 <br />Cdy/Stale7Zrp y\ ,�-t /, <br />APPLICANT: wrier Owner's Agent Contractor Contractor's Agent Tenant(mustpveoaaVrsvalma.erx o-am um a+ner to oo.on n ma spay/ <br />CONTRACTOR 0 LIMt v'- <br />State Lic # City Bus. Lic. # <br />Address <br />PhonerEmad <br />TENANT BUSINESS NAME <br />CONTACT FOR PERMIT <br />P",once rral DL3a—L-la� <br />BUILDING PERMIT APPLICATION <br />CONTRACT PRICE OF WORK ✓I� W <br />Existing Use of Building _ _ HEAT SOURCE. <br />Proposed Use of Building ' .) Gas_ Electric Other_ <br />Building type _ Single Family X Duplex _Townhouse _ Mulli-Family _ Commercial <br />Type of project Remodel Repair _ Sign _Sonkler Demolition _Change of Use <br />_o <br />DESCRIPTION OFWORK (admrionarspace providedonthe back) : <br />Ntt,'� 00�lle-y D3 S�h �fT f�l4 UV�I� <br />MECHANICAL PERMIT APPLICATION <br />PLUMBING PERMIT APPLICATION <br />Type of Project: _Ncv_ Addn _Alteration _Repair <br />Show Number (p) or frrfares <br />Type of Project: XNew_Addn _Alteration _Repair <br />Show Number (#) of fix fares <br />A/C - air handling units <br />2 <br />I Toilet <br />( Forced air systems <br />Gas piping <br />Bathtub <br />Lavatory (wash basin) <br />Water heater <br />I Shower <br />Gas fireplace <br />I Kitchen sink 8 disposal <br />Gas rangy <br />_ <br />Dishwasher <br />Clothes dryer <br />ri— <br />Clothes washer <br />I Range hood <br />_ <br />' <br />Exhaust fan <br />I Sink (servicelbarlmoplelc ) <br />_ <br />Heat pump <br />I Oackgow preventer _ <br />_ <br />Unit heater <br />I Urinal <br />Boiler <br />; Drinking Fountain <br />Refrigeration <br />Floor drain _ <br />Woodsiove <br />Grease trapzo <br />Ducting <br />Roof drains <br />Rdical <br />Other <br />M Gas <br />SPRINKLER I SUPPRESSION SYSTEM <br />I <br />Other: <br />Number of Heads <br />Other: <br />I hereby ceddy that I have read and examined this ap0 colion and know the same to be twe and coaecl All pmvis 0 ns of laws and ordinances govpm ing this type of work will be complied <br />with whether specified herein or nor The granting at a permit does not presume to give authority to wolele or cancel I" provision of any other slate or local law regulating conslradlon <br />That I am authorized by the ovmer of this property to perform the work for whtch applKalion is made and 1 comply whore Stale Contractors law 18 27 RCW and 296 200A WAC, <br />Owne*rtzcd Sig tature Dole (Revised 312073) <br />