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i <br /> PERMIT APPLICATION <br /> BUILDING/MECHANICAL/PLUMBING/SIGN/SPRINKLERIDEM1L.iTION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 Cedar SL, Everell, WA 98201 425-257-8810 FAX 425-257-8857 www.everettwa.org <br /> ApPLICATIONS ARE ACLEPTED FROM 8 AM TO 4 PM <br /> PROPERTY TAX p ERMI f# <br /> SITEADDRESS: �� � - — GG�c� <br /> < r15� Shvr� � vd, <br /> ��. y j.7�:'✓G. c �o�� <br /> LEGAL for neri consWction: Shoh PlaUsubdivision Lot No._ (attach copy ol'ong Iegal descriplion) <br /> OWNER �.fw:�^"' L. fi�v�hrt�* �Cl� Tra� � PhonelE�mail �(tY-;Y7-/V'dl <br /> / �,y•�/�D �� <br /> nddress ?Y�� l/i�tw� ��c•�r �9✓�� � c�ty�5�ate2�p CvvvrC��/ ��,ti <br /> APPLICANT:l.O�vner Owner'sA9ent CoNraetor Contraetor'sAgent _1�enant(m���ia�.�eoa��no«i«�:e�,u�o��•o��..-e��oaow;�k-�,�'ne:;soei <br /> CONTRACTOR �•vi �fw�e^ti� C�^Sf�ue i o L 8�Lic# COE Bus.Lic.# <br /> 8µi /.�1', M (t: t e �'� 982Ys Phone�Email 415-- 3Y$"- 3z83 <br /> Address �Zf v � <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT <br /> PhonelE-mail <br /> BUILDING PERMIT APPLICATION CON7RACT PRICE OF WORic <br /> HEATSOURCE: <br /> Existing Use of�uilding <br /> Proposed Use of F3uilding Gas_, Eledric_ Other__ <br /> Building type: _Single Family _Duplex_;ownhouse _A7ulti-Family _Commercial <br /> Type of projecl: __IJe�v _Addilion _Remo�el _Repair__T.I._Sign_Sprinkler_5 emoiition_ Change of Use <br /> DESCRIPTIONOFWORK(addhena�sp�reprordedaamebacx): , NL�j n I�-"`' ' <br /> /Jz�: - �- ,* ,ry �,:,, ., , . <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> TypoofProjecl: _New_Addn _Allcration_Repair Typoo(Projecl: _New_Addn _Allcration_Repair <br /> ShowNumber(N)olliafures ShowNumber(N1 o(/ixtures <br /> I NC—air handlin�untls ; Toilet <br /> � Forced air sys�ems I Bathtub <br /> j Gas piping I Lavatory(wash basin) <br /> Water healer I Sho�ver <br /> Gas freplace � Kitchen sink&disposal <br /> � Gas renge � I Dish�vasher <br /> � Clothes d��er I Clothes�•iasher <br /> Range hood � Water heater <br /> Lahausl(an � Sink(service/bar/mop/etc.) <br /> Heat pump I Datkflcw preventer <br /> � Unil hea�er I Urinal <br /> ! � Urinking Fountain <br /> � Ooiler <br /> Refrigeration I Floor drain <br /> Woodstove I Grease irap <br /> Ducting I Roo(drains <br /> Olher � Medical Gas <br /> SPRINKLER I SUPPRESSION SYSTEM I Other. <br /> Num6er of Hc,ds � Other. <br /> I I�nr.by cef I y thnl I�are read and c.am'�ned Ihis appllwLon antl know the same la be Ime antl corred.All provisione ol laws anE ordlnances Bcvern�ng t���is type ol wcrk�e���I be comF'^d <br /> e:dn�v^e:ecr=pecl�ie0 heiein er noL Tlm gmnling o1 n permH doea ncl0�esuma lo giva aulhen;y�o vblate o�cancel IM p�ovision ol any at0et sla'e or lo<al law repulating censL u:��e� <br /> �co�I:nn amher�¢eC Ey t�e owner ol Ihis propedy to pertorm Ihe xork forxfilch applicaticn ia maEo and I complp with mo Sta�e Conlractors law 1817 ftCW an�256.2 WA V�AC. <br /> � ��, � cY/0��/� <br /> Owcer/Authorized Aaent Siqnatum <br /> Dato a.A�d��d ann i�i <br />