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� __ � <br /> •a . <br /> _ �, ,,, <br /> $ �o��; <br /> � NERMIT APPLICAT19�v � ���,,�, <br /> BUILDINGIMECHANCCA o/PE ERSrNP IRS�IGsERPRENKL�/� � � ION <br /> - 3200 Cedar St., Everett, WA 98201 -425-257-8810— FAX 425-257-8857 —�rVerettw��rg " <br />�s yi � <br />��� , ApPLICATiONS ARE ACCEPTED FROM 8 AM TO 4 PM b�. 6 � (`''� <br />� �`� � � SISE ADDRESS: PROPERN TAx u P�RM� �� n�J <br /> � �� d <br />�, �U t y l-sf rlc�c� - -�e,-atF ,! � <br />��`� <br /> LEGAL(or new cons�mclion: Short PlaUsubdivision Lot No.__ (attach copy of long legal descriplinn) <br />�-.��,�. _. . ^ L;�.1� G�� � <br /> OWNER �' .�V �y rc:�'1 PhonelE-mail �G�U-� - _ . ,�� S"�;: <br /> � Address �Q ��y L� CitylS�a�elZip � 1JCJlr'Tt �l�%� �'S+�'iU� _. 1��� <br /> r j..::��� � 1 L&ILic. # DIZhCU1*�{�{061T � � } <br />�" "'�'"W''" CONTRACTOR D� � <br /> wn ��a. <br /> �ly(ti (.1clr fLuE�tNC. + C.L�1� <br /> ° �� nddress {��-� I�C�X . � v �A CS��,t�l,�. fr�r_....,� ;�i(.��c-i�4�- 3�14 .. _ +.r <br /> �- TENANT BUSINESS NAME ' CONTACT FOR PERMIT . ' .,sn;, <br /> 1 v�E-v ��XYrw<'�r�c..ii.v� � <br /> Phon?/E-mail 3(„(� - � � <br /> A �i4 <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK �o� `3`j�%"- " <br /> . . Existing Use of Building ��'� .cAr_.���_ HEAT SOURCE: <br /> " � � Proposed Use of Building Y'z`��u'c•.✓��� Gas_ Eiectric_ Other_ <br />� ��r..�.;: . <br /> � Building type: �Single Famity _Duplex_Townhouse _Multi-Famity _Commercial <br /> Type of project: _New _Addition �Remodel _Repair_T.I.__Sign_Spririkler_Demolition_Change of Use <br />- � Descrip�ion o(Work(addi(ional space p�avitledon fheGack): <br /> Y-�ria� �et�c�.- .��u�k�� ru-t <<:��4i„ ��e:_.: Cc.r.F-,r�; i��n roc:F <br /> Ye�C'la�� ����tfr,�'-� �4 cti.��.i.l i�lc��'C5 <br /> Hare you started working wilhout a permitl _YES �_NO <br />_ , ` MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> �:.�,,. � Typo of Projoct: _Now_Addn _Altorodon_Rapair Typo of ProJnct: _Nnw_Addn _Alloratlon_Rnpair <br /> y,� ..� Show Num6cr(#)oflixtures Shovi Number(#)ol/ixtures <br />�.. �. ��_ A/C-air handling units I Toilet <br /> � Forced air systems Bathtub <br />� Gas pipinq -� Lavator�(wash basin) <br />,!'y� Water heater � Showei <br />� Gas 5replace Kitchen sink 8 disposal <br /> � Gasrange Dishwasher <br /> Clothes d er Clothes washer <br /> � Ran e hood Water heater <br /> � � Exhaust fan Sink(service/bar/mopletc.) <br />"'�^ ������; � Heal pump Backflow prevenler <br />� � Unit heater Urinal <br /> � Boiler Drinking Pountain <br /> Refri eralion � Floor drein <br /> ���: j,� Woodstove I Grease irap <br /> `� �,'� Ductir� � Roof drains <br /> '! Other Medical Gas <br /> '- 5PRINKLER / SUPPRESSIdN SYSTEM other. <br />`,_, .. �� '' ' i Number of Heads I pther: <br />� <br />�^A •a 1 <br /> I hereby certify that 1 have read and examinetl this application and know ihe same to be Uue and wrrecl.All provisions of laws antl ordinances r�vemir9 <br /> . this tvpe of work will be complied with whe!ner specified herein or noL The granting of a permit tloes not presume lo give authorily lo vir^�a:r cancel <br />�� Ihe provision of any other stale or local law ulaling consimclion or Ihe pertoimance ol conslruction.That I am authorized by the ovmer of Ihis preperty <br /> h��' ' �o peAorrp Pr�wo for which appli t f�s made and I comply with the State Conlraclors Law 1827 RCW and 296200 WAC <br /> i <br /> � /���Lli�!�i ��-_ <br />�+U �� <br />,;�� Owrier/Authorized Agont Si�nolure Date (Revi5ed22011) <br /> �, i: <br />