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PERMIT APPLICATION <br />BUILDING/MECHANICALIPLUMBING/SIGN/SPRINKLER/DEMOLITION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 Cedar St., Everett, WA 98201 425-257-8810 FAX 425-257-8857 Www.everettwa.oLq <br />APPI MAMNS ARE ACCEPTED FROM B AM TO 4 PM <br />SITE ATIV_ <br />S: 3�` r5 (, Edegz(� <br />PROPERTY TAX <br />PER IT# <br />LEGAL for new construction: Short PlaVsubdivisk Lot No._ (attachgqcopy of long legal description) <br />OWNER /J`%`-/1DJ klr U-4 <br />PhonelE-mail LC`J 1�) t�� <br />Address s 0, OX -7 0/ jjuev- r <br />City/State/Zip <br />APPLICANT:_Ovrner _Ownees Agent ,KContraetor Contractor's Agent Tenant (muslproviCcalonercr consent/rem the comer to eonmkin lAe 'Pan) <br />CONTRACTOR G11CRGftGQN $TOT ,SNccr Mom- <br />IL & I Lic. # EVEIP—GS5 C>120T COE Bus. Lic. # 00-i55 <br />Address 'L17O C> ,t tC- AC EVERM-(IdA IS201 Phone/Email Qq-Z5) 252 --61/V <br />TENANT BUSINESS NAME <br />`' <br />�JEk)iOeJ Klt��+r <br />CONTACT FOR PER IT <br />�ZS, Z7Z. 3//v <br />lPhone/E-mail AIAWL MWA,C'O,N <br />BUILDING PERMIT APPLICATION <br />CONTRACT PRICE OF WORK (41.2-CO <br />Existing Use of Building Ot-G,/t HEAT SOURCE: <br />Proposed Use of Building S AwtL Gas_ Electric Other__ <br />Building type: _Single Family _ Duplex _Townhouse _Mlulti-Family ,Commercial <br />Type of project: _New _ Addition _. Remodel y Repair __ T.I. — Sign _Sprinkler _DemolitionChange of Use <br />DESCRIPTION OF theback)' <br />back): $o. <br />RC:P�cr OC6T-/N6 Ac- W/��f r w44r:IT AMP _ 5� 0sys <br />epoMQ✓'eSSor 15 f)2,/RDOG— I-L4 .Co2 (lam �2cn c'Nt <br />trA,11- Vdr ih4 PAD <br />MECHANICAL PERMIT APPLICATION <br />PLUMBING PERMIT APPLICATION <br />Type of Project: _New_Addn _Alteration _Repair <br />show Nunrhrr/#)of fixtures _ <br />Type of Project: _New_Addn _Alteration _,Repair <br />Show Number (#)of fixtures <br />A/C— eir handling units <br />I Toilet <br />Forced air systems _ <br />Bathtub <br />Gas piping <br />_ <br />1 Lavatory (wash basin <br />Water heater <br />Shower <br />3as fireplace <br />I Kitchen sink & disposal <br />_ <br />Gas range <br />Dishwasher <br />Clothes dryer <br />Clothes washer <br />Range hood <br />Water heater <br />—� <br />_ _ <br />Exhaust fan <br />if Sink (servicelbar/mo left. <br />Heat pump <br />Backflow preventer <br />Unit healer <br />Urinal <br />Boiler <br />Drinking Fountain <br />_ <br />Refrigeration <br />Floor drain <br />Woodslove <br />Grease trap <br />- <br />Ducting <br />Roof drains <br />Other <br />Medical Gas <br />SPRINKLER <br />/ SUPPRESSION SYSTEM <br />Other: <br />Number of I luads <br />Other: <br />I hereby certify that I have read and examined this appticatlon and know the same to be true and correct. All previsions of laws and ordinances governing this typo of work Vnll be complied <br />With whether specified herein or not. The granting of n permit does not presume la give authority to violate or cancel the provision of any other stale or local law regulating construction <br />That I am aulhorfzed by the owner of this property to perform the work for which application Is made and I comply with the State Contractors Low 10.27 RCW and 29e.200A WAC. <br />(Revised 6/2012) <br />Owner/Authori-. �d go:d Signature Date <br />