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• <br />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 WWW.everettv.a.org <br />SITE ADDRESS: <br />22Zfi Wz�Morr wrrdl� wA 9b�o( <br />PROPERTY TAX p <br />()C) 91L17 o1No( <br />P RMIT p <br />Gi0 biq <br />LEGAL -cr new Short PIJUsubdrviAan Lot No (attach copy of long legal description) <br />1constrichon <br />OWNER C7/ry t'j'7 v/ �L. �O E� <br />honelE maa PqL5-7cf/-Tl55 LJbAoo 7d Mor1.[ <br />Lhf� <br />Aodn:ss zZzt i WGT MO/C 1/6-C,ty/StatM2ip <br />A/c <br />Cr <br />GVC/Gi }'/L✓!T I f Zo ir <br />APPLICANT:_ Owner _Owner's_Agent onUacw, _C Contractor's Agent _'enant(".11om•e<.' m vw "ll.f c."..' aro.-�e•re i%, w*m..oacel <br />CONTRACTOR E <br />Jr' CLL <br />.T r;C S0lor <br />7 Stale L,c n A/OFI ES 1%761 City Bus Lic 905�z3 <br />rat n w 41 ,t p 4 (�' <br />Acofrss �� 1 � W VL W �CCr T r'� �✓n 1 U�y-I <br />Phone[mal <br />TENANT BUSINESS NAME <br />CONTACT OR PERMIT <br />-Lcn AlelSoh <br />nhone'F-mat L12S446-o5etl nw,,•C, <br />BUILDING PERMIT APPLICATION <br />sn$od� <br />CONTRACT PRICE OF WORK ,�,v,.,, .-7, firm <br />Exlsling Use of Budding f51.601 Ca JHEAT SOURCE <br />Proposed Use of Building CSI G/A(L'f o I&r V V �G fr6V Gas Electrc Other <br />..,, <br />Building type. xV Single Fa�f(�!ly _ Duplex _townhouse _ Multi-Famdy _ Commercial <br />Type or rolect. New / \' Add hcn Remodel Repair LI, Sin Sprinkler Demolition Change of Use <br />DESCRIPTION OF WORK iadd,f onal space f� p•omded on the back) <br />if, 5k,Ildfron L,P Cx r0440P Ll,rt(6kWJL Salejr, ITV Arrot/ <br />It -,Tier ITZ70 -270W r od lrs <br />IxrkckCEl+fk� 5,$k1✓ Titr;u Z7Tvr/fir/ <br />MECHANICAL PERMIT APPLICATION <br />PLUMBING PERMIT APPLICATION <br />Type of Project. _New _Addn _Alteralon _Repair <br />Show Number N of fixtures <br />Type of Project New _Addn _Alteration _Repair <br />Show Number a of fixtures <br />NC -air handling units <br />Todet <br />Forced airs stems <br />Bathtub <br />GasgiLilng <br />Lavatory wash basin <br />Water heater <br />Shower <br />Gas fireplace <br />Kitchen sink 8 disposal <br />Gas range <br />Dishwasher <br />Clothes dryer <br />Clothes washer <br />Range hood <br />Water heater <br />Exhaust fan <br />Sink seNice/bartmo fete <br />Heat pump <br />Backllow prevenler <br />Unit heater <br />Urinal <br />Boiler <br />Drinking Fountain <br />Refn e(ation <br />Floor drain <br />Woodslove <br />Grease Ira <br />Ductln <br />Roof drains <br />Other <br />Medical Gas <br />SPRINKLER / SUPPRESSION SYSTEM <br />Other. <br />Number of Heads <br />Other. <br />I hereby cendy trial I have mad and examined Ms apprealron and snow the same lobe true and wheat. All provisions of laws and ommances governing Iris type of wo& will be comp <br />with vieri specified barrel or nol. The graning of a panel does not presume to give authority to violate or cancel Ire pmvlsion of any other slate or local law regulating construction <br />Thal tam aWhonzed by the owner of this pmoeny to perform the "Afar which app6W bon is made and 1 comply with the State Contractors Law 18 27 RC W and 296 200A W AC. <br />Owner Authorized Agent signature Dale (Revised 912014) <br />