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PERMIT APPLICATION <br />BUILDING/MECHANICAL/PLUMBING/SIGNISPRINKLER/DEMOLITION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 Cedar St., Everett, WA 98201 <br />APPLICATIONS Ar"- ACCEPTED FROM 8 AM TO 4 PM <br />425 257-8810 FAX 425-257-8857 www.everettwa.Org <br />PROPERTY 7A%# P RMITN <br />SITE ADDRESS: <br />; V, �'l'r' /�1/� 61i c /:>4'r_"7T 1: /' Gc) �� ?�tC l G� S! 30 - <br />LEGAL for new construction: Short Plat subdivision Lot No.__ (attach copy of long legal description) <br />PhonerE-mail 4G' 535 3-�.�25 ShCQ�lx'r'n���n� <br />OWNER _To/1A)1- <br />Address 'j/O���CJ C�?� q v� G� City/Statel'lip ,P ✓CRG� (C)K/ <br />APPLICANT:_ Owner _Ownees Agent ontrector _ Contractor's Agent _ tenant (must provide a ruer cloomem from ere o..orr to do Am merpecs) <br />15 %�/ L & I Lic. # i1Cl 4196 041 COE Bus. Lie # <br />CONTRACTOR i� / -.`!'!vl�/rf <br />Phone/Email vrc /TY l{17 %Z-11C1`1>C X11 <br />CDyu/b>/>tlow � r,',y1 a <br />Address <br />TENANT BUSINESS NAME CONTACT FOR PERMIT /llf/7%S% S ,3(!"Q-�f y/-C� i) <br />Phone/E-mail /1 /l(!>/rt �!//%�7 ' L'ewn,-elco, C/5 <br />BUILDING PERMIT APPLICATION <br />CONTRACT PRICE <br />Existing Use of Building CA/\/I D/Z % HEAT SOURCE: <br />Proposed Use of Building/f/i /7J(,� j <br />Building type: _ Sit I Family _ Dupleex-(_Townhouse _ Multi -Family _Commercial <br />Use <br />Type of projecC t� New __ Addition _ Remodel _ Repair _ T.I. Sign Sprinkler ✓ Demolilion_Change of <br />DESCRIPTION OF WORK (additional space provided on the bath): / <br />9,x/ S7/tf6 a`441°oCT. <br />l02&,7r:/-1—I1oN OF aR <br />13u/1--D /tI�Gv Gc/aeT S�'r?C iu�� �2 <br />MECHANICAL PERMIT APPLICATION <br />ATION <br />PLUMBING PERMIT APPLIC-------------- <br />Type of Project: _New _,Addn -Alteration _Repair <br />Type of Project: _New _Addn _Alleration_Repair <br />Show Number (N) of fixtures <br />Show Number (a) of fixtures <br />A/C - air handling units <br />Toilet <br />Forced air systems <br />Bathtub <br />Gas piping <br />Lavatory (wash basin) <br />Water heater <br />Shower <br />I Kitchen sink & disposal <br />Gas fireplace <br />Dishwasher <br />Gas range <br />Clothes dryer <br />Clothes washer <br />Range hood <br />Water heater <br />Exhaust fan <br />I Sink (service/bar/mop/elcJ <br />Heat pump <br />I Backflow preventer <br />Unit heater <br />Urinal <br />Boiler <br />Drinking Fountain <br />Refrigeration <br />Floor drain <br />Woodstove <br />Grease Trap <br />Ducting <br />Roof drains <br />Other <br />Medical Gas <br />SPRINKLER <br />/ SUPPRESSION SYSTEM <br />01her: <br />Number of Heads <br />Other: <br />I hereby comfy that I hove read and examined this application and knowthe same to be uue and correct. All provisions of laws and ordinances geveming this type of vork wa be complied <br />with whether specified herein or not. The granting of a permit does nor presume to give authority to violate or cancel the prevision of any other state or local law reguWMg cooslrection <br />That I am authorized by the owner of this preperty to perform the work for which application Is made and I comply with the State Contractors Law 18.27 RCW and 290 200A WAC. <br />Owner//gt(lBoriz d gent Signature Date <br />ozs. <br />(Revised 612012) t/2— <br />\\ <br />