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E <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.everettwa.org <br />SITE ADDRESS: <br />202-1;f e sA- <br />PROPERTY TAX X <br />11 Q o 5 Oil <br />PERMITS <br />Gt H 0 13 <br />LEGAL for new construction' Short Lot No _ (altach copy of long legal description) <br />,Pla`Vsubdiwsion <br />OWNER VAo-'1 DY-)/ci t'/ cx-i, ` , T <br />honi mail y; ( t r, GiC-p��1' et ' <br />{� <br />Address I C) 1 ;/ 1 r I Os &A, f�� <br />�NA4 <br />City/Slate/Zip �l •)=�W"�-'/k-=,�j"a Z2.. <br />APPLICANT: Owner Owners Agent Contractor Contractor's Agent _Tenant (mva prov,Cealeaer arwnsenn,nn mo owndno do wma, ma tpacel <br />CONTRACTOR VJ <br />State Lic. # SO NG I kc) Y-M City Bus. Lic. N <br />Address Phone/Email 7j -Li 345 -S 0 S <br />TENANT BUSINESS NAME JCO)t3A�L FOJ2�PURAQIL , 4ylPhoe/E-mail j /�N/J�1�J ��"— <br />BUILDING PERMIT APPLICATION <br />CONTRACT PRICE OF WORK <br />Existing Use of Budding HEAT SOURCE <br />Proposed Use off/ Bundling 3 BD 15G Gas_ Elechi Other_ <br />Building type. XSSingle Family _ Duplex _Townhouse _ Multi -Family _ Commercial <br />Type of protect/- New Addition Remodel _ Repair _ T.I. _ Sign Sprinkler _Demolilion_Change of Use <br />_ <br />DESCRIPTION OFWORK (additional spaceprowdedonthe back): 1J pr)%Z Z 5���/ Sl✓I t{ FClWtlly <br />MECHANICAL PERMIT APPLICATION <br />PLUMBING PERMIT APPLICATION <br />Typo of Project: XNew _Addn _Alteration _Repair <br />Show Number (0) of fixtures <br />IT ype of Project: ZNew _Addn _Ateration _Repair <br />Show Humber {el of fixtures <br />A/C - air handling units <br />Forced air systems <br />I Toilet <br />Bathtub <br />Lavatory (wash basin) <br />Gas ipin <br />Water heater <br />Shower <br />Gas fireplace <br />Kitchen sink & disposal <br />Gas range <br />I <br />Dishwasher <br />Clothes dryer <br />Clothes washer <br />Range hood <br />Water heater <br />Exhaust fan <br />Sink (service/badmop/ell; <br />1 Backflow preventer <br />Heat pump <br />Unit heater <br />Urinal <br />Boiler <br />Drinking Fountain <br />Floor drain <br />Refrigeration <br />Wcodslove <br />Grease trap <br />Ducting <br />Roof drains <br />Medical Gas <br />Other <br />SPRINKLER/ SUPPRESSION SYSTEM <br />j Other <br />Other: <br />Number of Heads <br />I hereby certify that I lave lead and examined Ibis appficallon and know the same lobe line and correct All promsions of laws and ordinances governing this type of work we be comptrcd <br />with whether specified herein or not. The granting of a pert does not presume to give aNhorty to violate or cancel the provision of any other stale or local law regulating consWction <br />That I am onied by In owner oI in properly o perlor the work rot which application is made and I comply wits the State Conlradors Law 18.27 RCW and 296 200A WAC. i[ <br />M <br />Owner/ thorized Agent lure Dale (Revised32013) <br />