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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 wvAv.evertt a./r <br />SITE ADDRESS: PROPERTY TAX # PE 1T <br />I_ -7-02 <br />I u <br />LEGAL for new construction: Shod Plat/subdivision Lot No (attach copy of long legal description) <br />OWNER <br />Phone/E-mail �S - ,� - <br />Chi <br />Address 1 0 J (X„r.1�L b1` <br />City/State/Zips ETr WYT 8aag <br />APPLICANT:_ Owner _Owner's Agent XContractor _Contractors Agent _Tenant lmun pmnae eienrr or comem o-om coo owner la ao won mare spasm <br />1 LL iici. �q c)T{� City Bus. Lic. # <br />CONTRACTOR �i(AALA?46 tl <br />State <br />Q# <br />/ <6 <br />17 ZSN WA 594 Phone/Email XQ6- S-W-y'20S <br />Address I ' (�,S`C JIB <br />TENANT BUSINESS NAME <br />CONTACT FOR PERMIT <br />Phone/E-mail <br />BUILDING PERMIT APPLICATION ICONTRACT <br />PRICE OF WORK — <br />HEAT SOURCE. <br />Existing Use of Building _ <br />Proposed Use of Building Gas_ Electric other_ <br />Building type: K Single Family _ Duplex _Townhouse _ Multi -Family _ Commercial <br />Type cf project: _ New _ Addition Remodel Repair T.I. _ Sign _Sprinkler _Demolition_ Change of Use <br />DESCRIPTION OF WORK (additional space provided on the back): 'J�NSTkk� NEB UIKTLeSS H-eti y.ap, <br />MECHANICAL PERMIT APPLICATION <br />PLUMBING PERMIT APPLICATION <br />Type of Project: _New _Addn _Alteration _Repair <br />Type of Project: _New _Addn _Alteration _Repair <br />Show Number (#) of flxfures <br />Show Number (#) of fixtures <br />A/C - air handling units <br />Toilet <br />Forced air systems <br />Bathtub <br />Gas piping <br />Lavatory (wash basin) <br />Water heater <br />I Shower <br />Gas fireplace <br />Kitchen sink & 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/mop/etc ) <br />i <br />Heat pum <br />Backfiow prevenler <br />Unit healer <br />Urinal <br />Boiler <br />Drinking Fountain <br />Refri eration <br />Floor drain <br />Woodslove <br />j Grease trap <br />Ducting <br />j Roof drains <br />Other <br />Medical Gas <br />SPRINKLER / SUPPRESSION SYSTEM <br />Other: <br />Number of Heads <br />Other: <br />1 hereby certify that I have read and esamined this application and knew the same to be true and correct. All provisions of laws and ordinances goveming this type of work will ba complied <br />with whether spedned herein or not. The granting of a permit does not presume to give authority to violate or cancel the provision of any other state or local law regulating construction <br />Awn.rl <br />olhorlledby the ownerofthisrtyto peoormthe workfor which application is made and I comply with the State Contractors Lew 16 27 RC W and 296.200A W'AC. <br />7/1/3uthorized Agent Signature Uate (Revised 312013) <br />