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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 vi%meverettwa.org <br />A oor v-AT!0NQ APP Ar:CFPTFn FROM R AM TO J PM <br />SITE ADDRESS: <br />z 'f i suet e' lkJA. <br />PROPERTY TAxd <br />Q�RMIT 9. / ,„ � <br />n (xf <br />LEGAL for new construction: Shh.n�PlaUsubdivision Lot No._ (attach Copy of long legal description) <br />OWNER LivylaI.x111` S <br />Phone/E-mall <br />Address <br />City/State/Zip <br />APPLICANT:__ Omer Agent Contractor Contractor's Agent _Tenant peasp.m..enerarmmwt tare the —wto remark, me.peul <br />_Owner's <br />CONTRACTOR kOn <br />L&ILic.9 COE Bus. LIc.# <br />.Arr� <br />Address n .o Ze 1' L • �� L-vin wG�CiC� PhondEmail , ; Ips <br />. , /Qj j !15 /Cl <br />TENANT BUSINESS NAME <br />CONTACT FOR PERMIT <br />La,-il �.( e3gV-32 <br />PhenelE-mail zL � <br />BUILDING PERMIT APPLICATION <br />CONTRACT PRICE OF WORK -I t4 I <br />Existing Use of Building Q2 j HEAT SOURCE: <br />Proposed Use or Building Gas X Electric Other_ <br />Building type: XSinglo Family _ Duplex_Townhouse _Multi -Family _Commercial <br />Type of project: New Addition Remodel Re air_ T.I. Sign -Sprinkler Demolition Change cruse <br />DESCRIPTION OF WORK (addlflonal spa to p oNded on the bete): <br />Dern� hour-e_ 145t <br />MECHANICAL PERMIT APPLICATION <br />PLUMBING PERMIT APPLICATION <br />Type of Project: _New_Addn —Alteration _—Repair <br />Show Number (Q of fixtures <br />Typool Project: _New_Addn -Alteration —Repair <br />Show Number (e) of fixtures <br />AIC-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 range <br />Dishwasher <br />Clothes dryer <br />Clothes washer <br />Ran a hood <br />Water heater <br />Exhaust fan <br />Sink (service/bar/mo letc.) <br />Heat um <br />Backgow preventer <br />Unit heater <br />Urinal <br />Boiler <br />Drinking Fountain <br />Refrigeration <br />Floor drain <br />Woodstove <br />Grease <br />trap <br />Ducting <br />Roof drains <br />Other <br />Medical Gas <br />SPRINKLER <br />/ SUPPRESSION SYSTEM <br />other: <br />Number of Heads <br />Other: <br />I hereby cen�ty that I havo.sad and esamhed thb applkallon and know the some to be true and caned. AN pm is oos of lam and nrd0dnms goveming this type of work wil be mmpfed <br />wen whetherspecieed hereln or not. The granting of a permit does not presume to give authority to violate or cancel the prevision of any other stale orlml law reguHling mmbueeon <br />That I am authodzgd by me owner of this property to perform the work I" Which appkaDan Is made and 1 mmplywth the Slate Contractors Law 1e.27 RCW and 299.200A WAG. <br />or-2B•13 <br />(Revised &2042) <br />