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From <br />05 # 2013 08:54 <br />#462 P.002/002 <br />PERMIT APPLICATION <br />BUILDING/MECHANICAL/PLUMBING/SIGN/SPRINKLER/DEMOLITION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 Cedar St., Everett, WA 98201 425-257-8810 FAX 425-257-8857 wynv eve ell va erg <br />APPLICATIONS ARE ACCEPTED FROM R Ann TO a PM � 1,� Z <br />1 SITE ADDRESS: r O� ry PROPERTY TAX N -(yam`, �) p[ MT p — <br />J /•� r-z r _c 7Qr2?_Q..D <br />LEGAL for new Wnslrucl:on. Shen P,aVSubdrvislph _Lot No (attach copy of long 49a1 descnpeon) <br />OWNER 9trm-m-ti <br />Phone/E-mall (43 —99"CiR <br />Address 5oa. <br />CIIy/State/ZIp <br />APPLICANT:_Owner _0wnet'5A,9enl Cont1ractor�Contractors Agent linen DmvMeabnnr alpromnm tram me owern Jpwon mlb ep�ce) <br />r_lCnlnt <br />CONTRA CJM & - \Na1e.,c Ir'r�'Tp-�t L 8 I Lie # 1 S�`"J� t`�'IL $pC. COE Bus. Lic #i 3 <br />Adore.:: 11715 North Creek Parkway Sty C-106 Bothell, WA 98011 L' Phonelrmail Ml <br />TENAN-1 ounini nnrnc i..krnrrkcT FOR PERMIT <br />ck2a-l[-ICY�-1 J'C-SS1 (1D. Vr �-Sa'1 <br />Phony/6ma11 �(- tit � S ,L�+Ir-1/L <br />BUILDING PERMIT APPLICATION <br />ICONTRACT PRICE OF WORK X <br />Existing Use of Building <br />HEAT SOURCE. <br />Proposed Use of Building <br />Gas Electric__ Other <br />-- <br />Building type: XSingle Family _ Duplex _Townhouse _ Multi -Family Commercial <br />Type of project: __ New Addition _ Rornodel Repair T.I. _Sin S rinkler Demolition Change of Use <br />DESCRIPTION OF WORK (additional space provided on the bath).` <br />MECHANICAL PERMIT APPLICATION <br />PLUMBING PERMIT APPLICATION <br />Type of Project: _Now _Addn _Alteration _Repair <br />S_huw Number (p) of fixtures <br />Type of Project, New _Atldn _Alteration _Repair <br />Show Number (a) of fixtures <br />A/C -air handling units <br />Toilet <br />Forced au s slams <br />Bathtub <br />Gas piping <br />Lavatd (wash basin <br />Water healet <br />Shower <br />Gas fireplace <br />Kitchen sink 8 disposal <br />Gas range <br />Dishwasher <br />Clothes dryer <br />Clothes washer <br />Rana hond <br />Water heater <br />Exhaust fan <br />Sink (servicelbadmopjeu <br />Neat pump <br />Backflow prevonler <br />Unit heater <br />Urinal <br />_ <br />Boiler <br />Dunkin Fountain <br />F— Refri�ra Pon <br />Floor drain <br />I Woodslove <br />Grease Ira <br />Ducling <br />-- <br />Roof drains <br />Other <br />PAedical Gas -- <br />SPRINKLER / SUPPRESSION SYSTEM <br />Other: <br />Number of Heads <br />Other. <br />herebyee lid, thin I have rand and erenrnerl lhh apptoollan and know die 9amb tube eve and 0onod All pmvdianD or laws and or francCk governing lid type 01 wark v 1p be compnud <br />wish whOmer IpeGlud heroin or not The granting of v Pmmn ogee not p101 ume to she autilwily 10 v101910 or aincol fhb provision of any other s,aid or lawn law regulating con flmcllon <br />That I um nvthodsotl by the owner of on, pmpedy to Perform 'no work for width eyplxelien Is ma do and I compty wdb the Stele CunPaclore Low 18 27 nCW pad 296 200A WAC. <br />r I uthorlxA od 4gent Signoture I 1 Oato <br />(Revised 6)2012) <br />Vn <br />