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PERMIT APPLICATION <br />BUILDING/MECHANICAL/PLUMBING/SIGN/SPRINKLER/DEMOLIT,�ON <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 />N I 1- chw <br />PROPERTY TAX # <br />005-000-0y -0 <br />PERMIT <br />=5w <br />LEGAL for new construction: Short Plat/subdivision 12-02- 0 30 - 01i 5P Lot No. 2 (attach copy of long legal description) <br />OWNER i <br />eo <br />Phone/E-mail 'r' <br />`` <br />Address / � ).0L <br />City/Statemp 8 <br />APPLICANT: —Owner _Owner's Agent /Contractor _Contractor's Agent _Tenant imaslpmvdoaloSclrelmnientnomooe nertedowo*tn Mespaw) <br />CONTRACTOR 4 ` <br />State Lic. # I h � D2 City Bus. Lic. # <br />Address 71/ 'ra-PL NC 4L 11c, WC!, 9 ZjZ Phone/Email IleA /16.2 J.CtArr\ <br />TENANT BUSINESS NAME <br />CQNTACT FOR PERMIT <br />3i6o-7zz-ds-iY <br />j �r[in <br />hone/E-coal ", P&C11 <br />BUILDING PERMIT APPLICATION 11CONTRACT <br />PRICE OF WORK <br />Existing Use of Building <br />HEAT SOURCE: <br />r� n <br />Proposed Use of Building 5 I1 <br />Gas I Electric_ Other_ <br />Building type. _)L Single Family —Duplex _Townhouse _ Multi -Family _Commercial <br />Type of project: _)L New _ Addition _ Remodel _ Repair _ T I. _ Sign _Sprinkler _Oemolition_Change of Use <br />DESCRIPTION OF WORK (adddlonal space provided on the back) : <br />1Uc�,J s FKI on qo-� �- )--o� <br />MECHANICAL PERMIT APPLICATION J1 <br />PLUMBING PERMIT APPLICATION <br />Type of Project: YNew _Addn _Alteration _Repair <br />Typo of Project: XNow _Addn _Alteration _Repair <br />Show Number (#) of ffxfures <br />Show Number (A) of fixtures <br />A/C - air handling units NJ <br />Toilet <br />Forced air systems 6i <br />Bathtub <br />Gas piping <br />Lavatory (wash basin) <br />Water heater <br />J <br />Shower <br />z <br />Gas fireplace <br />Kitchen sink & disposal <br />Gas range �- <br />J <br />Dishwasher <br />Clothes dryer 4 <br />Clothes washer <br />Range hood <br />Exhaust fan 11 <br />Sink (service/bar/mop/etc.) <br />Heat pump a <br />Backflow preventer <br />Unit heater '8 <br />Urinal <br />Boiler <br />Drinking Fountain <br />rl <br />Refrigeration <br />Floor drain <br />Woodstove <br />Grease trap <br />Ducting <br />Roof drains <br />Other <br />/ SUPPRESSION SYSTEM <br />Medical Gas <br />SPRINKLER <br />'s <br />Other: <br />Number of Heads <br />Other: <br />I hereby cedAy Thal I have read and examined this application and know the same to be [me and toned. All provisions of laws and ordinances governing thts type of work will be complied <br />wah whether speed herein or not. The granting of a permit does not presume to give authority to violate or cancel the provision of any other stale or local lav regulating construction <br />That I am authorized by the owner of this propony to pedorm the work ftr which application Is made and I wmply with the Stale Contractors Law 10.27 RCW and 296 200A WAC. <br />� t y <br />Owner/Authorized Agent Sigirlature Dale (Revised 3/2013) <br />