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( ' <br /> PERMIT APPLICATION <br /> BUILDINGIMECHANICAUPLUMBINGISIGNISPRINKLEWDEMOLITION <br /> CITY OF EVERFTT PERMIT SERVICES <br /> 3200 Cedar St., Everett,WA 98201 -425-'L57-8810-FAX 425-257-8857-www.evereriwa.org <br /> APPLICATIONS ARE ACCEPTED FROM B AM TO 4 PM <br /> SITEADDRESS: YROPERtt7AXM P � � O <br /> I�iUS W��RE NVE EuERET'� II 'O � <br /> LEGAL for new conslruction: Short PlaVsubdivislon Lot No._ (atlech wpy of long Iepnl descrfplion) <br /> OWNER c.NARi.Es � BAKF.� Phone/E-maii zolo-z�z•�3o9 ch�lsbkr al�. <br /> Address t`ItiS IoTM a�� w .�1 Cunt�� (.t�.On� CitylState2lP SEAT'f� WA Il <br /> CON7RACTOR 7R/��15 TI�SEN� F WYNc W L 8 1 Lic.# FKAM�C� 01 K <br /> Address 5716 Iyy'�` St $E Ev�R�tT W� PhonelEmail �IZr•ZI�•y�°7 <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT <br /> Phone�-mei� �-�' Z�2-�3Ci� /�- YS3"-363� <br /> BUILDIN6 PERMIT APPLICATION CONTRACT PRICE OF WORK s �°� °CO "'��5�� <br /> Existing Use oi Building RCS���GE. _ HEAT SOURCE: <br /> Proposed Use of Building RESI DE►.1� Gas Electric Other <br /> Building type: �Single Family _Duplex_Townhouse _Multi-Family _Commercial <br /> Type of projecl: _New _.Addition �Remodei �C Repair_T.I._Sign_Sprinkler_Demolition_Change of Use <br /> Description of Wofk(edditionel sp aca provided on tAe back): <br /> ��REhTE GwSET kND A�.tpv` FoR 6EOarwM, oPS�1+�14 WfST [INTE ��� M�£ � <br /> FRf.m�4` q°AcE F Ronn A�7ar.�.N� RcnM ,aE���T� .!/)d�.!/ S 2� <br /> <sEe � ) �,/ <br /> Have you ateRed working wlthout a permit7 _YES _NO � <br /> MECHANICAL PERMIT APPLICATION PLUMBING MIT APPLI TI N // // <br /> Typa ol ProJect: _Naw_Addn _Altantlon_Repair Typa of Pro�ecl: _Naw_Addn _Altenllon_R�p�ir <br /> Show Number(N)olllxturea Show Num6er(Mj o:flxturer <br /> A/C—airhandlin unils Toilel <br /> Forced air s stems Bathlub <br /> Gas i in Lavato wash basin <br /> Water healer Shower <br /> Gas f re lace Kitchen sink S dis osal <br /> Gas ran e Dishwasher <br /> Cbthes d er Clothes washer <br /> Ran e hood Waler heater <br /> Exhaust fan Sink service/bar/mo /etc.) <br /> Heat um BackFlow reventer <br /> Unit heater Urinal <br /> Boiler Orinkin Fountain <br /> Refrigeration Floor drain <br /> woodstove Greese tra <br /> Ductin Roof drains <br /> Other Medical Gas <br /> 8PRINKLER/ SUPPRESSION 8YSTEM Other: <br /> Number of Heads Other: <br /> I hereby cerlity ihal I have read and examined Ihis applicatlon and k�iow lhe same to be irue and r.orrect.AI�provisions ol lawa and ordinancea Bovemi� <br /> this type of work will be wmplied wi�h whelher specified herein ar not.The granling ol e permit dces not presume to give authority lo violale or cencel <br /> lhe provision ot any olher state or lowl law regulating conslruction or lhe perlortnance ol consiruction.Thet I em aulhorized Dy the owner ol thls property <br /> to peAonn ihe work for which applicetion is made and�comply wilh Ihe Stele Contractors Law 18.27 RCW and 298.200 WAC <br /> �O� L, �� tf�d/�� <br /> OwnorlAuthorl:adAgent5lgnature Date (Revisetl7/2011J �� <br />