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PERMIT APPLICATION <br /> � BUILDINGlMECHANICALIPLUMBINGISIGN/SPRINKLERIDEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 Cedar St., Everett,WA 98201 -425-257-8810—FAX 425-257-8857—w�vw.everet or <br /> APPLICATIONS ARE ACCEPTED FROM e AM TO 4 PM �— ��)� <br /> SITEADDRESS: W���� Pgpv_� tAxa iTp <br /> (�YJ <br /> LEGAL for new construction: Short PlaUsuUdivision Lot No_ (attanc�opy of long lepzl descdpUon) <br /> OWNER �LE I I NN " Phorm/E•mail �',7 r?j ,'7' <br /> Atldress � �'� rjC CitylState/2ip S � <br /> CONTRACTOR D — T L&I Llc.# /v� �- <br /> Address . /�f� R-16� Phone/Emaii �Zl'7 /✓"�c%y6 <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT 2�� ��� �CLIr� <br /> r�p�Y / <br /> PhonelE-mail �-(2�' 777r`�G' <br /> BUILDING PERMIT APPLICATION coNTanCT PRICE OF WORK C <br /> Existing Use oi Building HEAT SOURCE: <br /> Proposed Use of Building Gas � Electric O;her_ <br /> Buildinglype: _SingleFamily ,�Dupiex_Townhouse _�dWti-Famliy _Commercizl <br /> Typeofproject: _New _Addition _Remodel _Repalr_T.! _Sign_Sprinkler_Demolition_Change otU:e <br /> DeScriptionofWotk(addifionalspaceprovidedonfheb2ckJ: �?��7�GE �j(IS�77r11C� C»f�5 (�/ W�1��12 <br /> �'_ <br /> �M�K W��-1 A- N F%G�7 �'9� ��-s�,, �NOT l,l��cT�"� T>tN :�N TH� 5�+`i`'� <br /> Have yCoflu t rted worl�ing wiil out a pe�r� =��ES�NO v � <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> TypeotProJecL _New_Addn _Alteretlon_Repalr TypeofProJect: _New_Addn Alteration_Repair <br /> Show Numbcr(k)o//ixturns 5l�ow Nom6er(CJ ol/ixtur.�s <br /> WC—�irhandlinauNts I Tollet <br /> � Forced air s slems � Bathtub <br /> � Gas pipina � Lavatory(wesh basin) <br /> � Water heater Shower <br /> � Gas Iirepiace Kitchen sink 8 disposal <br /> Gas ran�e � Dishwasher <br /> � Clo;hes dryer � Clothes washer <br /> � Ranoe hced � VJater hezler <br /> � Exhaustfan � Sink(servicePoarlmo letc.) <br /> � Heal ump Backilow revenler <br /> Unit he�ter Urinal <br /> Boiler Drinklno Fountain <br /> Retrioerztion Floor drain <br /> Woodstove Grease Uap <br /> � Duclina Roof drains <br /> � Other� MEdical Uas <br /> � SPRINKLER /SUPPRESSION SYSTEM other: <br /> Num6er ot Heads Other: <br /> I hereby certiy that I r�=�e rezE srA e�miried thls epp!ication and knrnv the same to be true and correcL All provisions oi lam and arGinances goveming <br /> ihis type o`vrork wif;n complied with whether specif,ed hereln or no!The QranVnB of e pertnit tloes nol presume to pive authorrty to vlolate or wncei <br /> the provislon of eny o;her state or local law regulaUng consWclion or the peAortnance of wnsWction.That I am euLhor¢ed by the wmer of this propedy <br /> to perforrfrtfi�work for which Fpplica ion is m snd I wmpiy�M;h ihe afe onVactors Law 7827 RCW and 296.200 WAC <br /> � ,L � 9y <br /> OwnerfAulho edAgentSigna ate (Revlsed9l201iJ <br />