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PERMl� APPLICATION <br /> BUILDINGIMECHANICAL/PL(�MBING{SIGN/SPRINKLERIDEMOLITIAN <br /> CITY OF EWEP.ETT PERMIT SERVICES <br /> 3200 Cedar St., Everett, WA 98201 47.5-257-8810 FAX 425-257-8857 www.everetlwa.or;; <br /> ..._ �D — ' � <br /> SITEADDRESS: � f PROPERNTA%p PERMIix <br /> 5,o i 2a — R,�u.e. . c,� ' � o - 01 <br /> LEGAL for new conslruciion' Short PlaVsuhtlivision Lol No._ (altach�:apy of Iong legal descriplion) <br /> OWNER Gar �ockery t �'Ib.ry Clb, 0 phonelE-mail L�25� 3Ng- ��S <br /> Address <br /> 5�d 1 23= .�J¢µ�.lC. (,J Cily/SlalelZip �Je�TT� (�fL 1p2�3 <br /> APPLICANT: Owner OwnersAgent _Contracror ConlraclofsAgent TCOdfl��musipmHCaaletetcl�onsenL'remNov.vner!odowa�kinNaspace) <br /> CONTRACTOR Crflaf.Ja �� # �e Stale Lic./t CRE�I�l��l CO Cily Bus. Lic.# <br /> Address ���$ M"�`1'�6tl ��`'jO' �'y"""1Q0���Phcne�[mail CyZ� 2�2'2222 <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT ��Ou�eti 11 <br /> PhonelE•mail ��25� 2�2-Z2?,Z 'raJC�n�Cfe4�l�1[N� <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK � t6O� <br /> Ezisling Use of Building S`�9.� ' '"�'�'I �5, e�2 HEAT SOURCE: <br /> Proposed Use ot Building 5k�t(c Gas__._ eleciric_ Omer_ <br /> Building lype: �Sirgle Pamily _Duplex_Tovmhouse _Multi-Family _Commercial <br /> Type of project: New _Addilion �Remodel _Repaii__T.I. _Sign____Sprinkler_Demolition__Change of Use <br /> DESCRIPTIONOFWORK(addil�ona�spacep�ovidedoorheeack): epy�h� ������o $ �.xT�aJ'a5 Q-'r�. <br /> �e��noctc.� l�.�s�c �� en le�.x� �ee�': � f. e , r <br /> tJ:ll o,�,0.C1� tq.14't3l� '� re�ew�re. sc+++e. c�est�c -Y/law,:n� � <br /> MECHANICAL PERMIT APPLICATION PLUM613�G PERMIT APPLICATION <br /> Type of Prajoct: _New_Addn _Alleretion_Repalr Typo ol Project: _Now_Addn _,_Allera�ion_Repair <br /> Show Num6er(M)o/Ilxtures Show Num6er(MJ ollixfures <br /> NC-air handling units i Toilet <br /> I Forced air sys!ems � Bathlub <br /> � Gas piping � � Lava�ory(wash basin) <br /> � Wa�er healer � Shower <br /> Gas Greplace �_ Ki(chen sink 8 disposal <br /> Gas range Dishwasher <br /> I Cblhes dryer I Clothes washei <br /> i Range hood I V'1a�er healer <br /> � Fxhausl lan � Sink(servicelbadmop/etc.) <br /> � Heal pump � Backllow preventer <br /> Unil healer � Urinal <br /> � Boiler Drinking Founlain <br /> � Refrigeration � Ploordrain <br /> � Woodstove I Grease Irap � <br /> �uctiny I RooFdrains <br /> � Other Medical Gas <br /> SPRINKLER / SUPPRESSION SYSTEM � olncr <br /> Num6erofHeads I Olher. <br /> I�ercCy ceNfy Ihal 1 have iead anE examined this appiication and know ihe same lo�e true and cmiecl.All p�o�;ion,ol laws nnd orCinunces govemin9:his type ol work vn'I Oe romp6ed <br /> weh whclhcr:pecifed�ercin or nol.The gianling ol a perm�Eacs not yresume l0 9ive wl�onry lo violalc or wnccl I�c provrsion ol any o1�a s�alo or Iocal Iaw�c9Wabnp cons�mclian <br /> Thal I am amhorixetl by�ne ownei ol Ihis propetly to pertoem Ihe woik lo�wAich appliwlion is maar and i mmply vnlh I�e Slale Coniractors Law IB P IiCW and 19fi 200A WAC <br /> �V��„n g .�Ju+e�. (o�Zo�l�l <br /> OwnodAuthorized Aganl Sig�aturc Dalc (Revised3R013) <br />