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PERMIT APPLICATION <br /> ' BUILDIN MECHANICA 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 /> SI'f t?ADDRESS: }^--,c-) ,) ).:rid --.)t -.Y_ i !° PRS/ `vJ OPEATIT #' ' ''Cl;)-2-. ).C.,''14,0-\.-.) PEI , /j7 <br /> j7 —O,A <br /> LEGAL for new construction: Short Plet/subd1vislon Lot No. (atteah copy of long toga!description) <br /> OWNER t lJo.1 phone/�tnall G G - 6,t Lf,�' "_ �f S/ <br /> _ ti <br /> '`7' i ar,`,,� fj �f'�, <br /> Address - i �� Cdyisbate/Z J'!v ec(' , L,i;' q.-0 O 1 <br /> 1 <br /> APPLICANT: Owner Owners Agent Ortira t t ContrucdoraAgent _Tenant(mumnpre dtra team-eciarp4at tarnft raat&weonarh*/the ) <br /> CONTRACTOR OR /, 7 11 LRSO ' ' State�c l )i� C 1.! / City Bus.t ic.# 0 53 ' -• <br /> Address TOO kite] L / 5 fu` k A f et/taut Oa qb(yV I 1 PhoI JEmait .CO '11p4 Wadi it + ;+ `x"41 <br /> 1 : Bu- "4:L . . .NTAc�J"F.. ' -ti. <br /> cJG_Ct✓iGc 1. <br /> Phone/E-mail . d/ � . . a <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK Or.. <br /> Existing Use of Building I1� -;1j,f,,V\;J'e, HEAT SOURCE: <br /> Proposed Use of Buitdirlg - �%�_ � Other -- <br /> Building type: _Single Family _Duplex Townhouse Multl-Fainly _Commercial <br /> Type of project: New Addition Remodel„Repair MI Sign Sprinkler DernOrrtiOn Change of Use <br /> DESCRIPTION OF WORK fettaitibrialspw providedon the hack): <br /> , J Nf <br /> (._._. _,.s ,kajo� s.) <br /> keirilovq_ c,fr aplai-c <br /> MECHANICAL PERMIT APPLICATION 1 PLUMBING PERMIT APPLICATION ""t <br /> Type of Project _New Addn Alteration Repair Typo of Project New Addn Aluxation_Repair <br /> , Show Number(#)of Iixturese,0 17;1Al i°. Show Number( )of Wines <br /> NC—air handling units ' ' Toilet <br /> Forced air systems i Bathtub <br /> Gas pipit I y w <br /> Lavatorash basin) t <br /> Water heater Shower ,_„ <br /> Oae fireplace _ Ktchan sink&disposal —4�— Gas range Dishwasher <br /> Clothes dryer _ Clothes washer <br /> Range hood Water heater <br /> Exhaust Ian • } Sink(service/bar/mop/eta) <br /> Heat pump Backflow preventer <br /> Unit heater Urinal <br /> Soifer Drinking Fountain <br /> • <br /> Refrigeration _ _ ! moor drain <br /> Woodstove + Grease trap <br /> LDucting Roof drains <br /> Other Medical Gas <br /> SPRINKLER 1 SUPPRESSION SYSTEM j Other. <br /> I. Number of Heads _ � Other: <br /> I hereby oen y that!have read me examined this opp etlon and rmow the same to be the and oarract Ail provisions of laws and erdhtanc85 QOVdrt1ing this type of work wli be tempt <br /> with whether spat:Olee herein or not The granting ora permit does not presume to give authority to violate or cannel the pmvlsion of arty other state or low law regulating construction <br /> Thal i am $kfbrited by tote owner of ails property to perrfforpm the work N.which application is made and t Comply[with ore Siete Contactors.taw 18.27 RCW and 2e 2OOn WAC. <br /> owner/Authoi1zed Agent 5ignatvre- Date (F2cvised 9x1014) <br />