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. . I�'���o�� o <br /> PERMIT APPLI A N FEB 2 1 Zp12 <br /> BUILDINGIMECHANICAL/PLUMBING/SIGN/SPRINKLER/��dCl�$J�KS <br /> CITY OF EVERETT PERMII SERVICES <br /> 3200 Cedar St., Everett,WA 98201 -425-257-8810—FAX 425-257-8857 —www.everettw2a.oprq <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM U '/�Z <br /> SITEADDRESS: PROPERTVTA%p PE MITp <br /> pp tK r z o 00 o2-OG <br /> LEGAL lor new conslruclion: Shotl PlaVsubdivision Lol No._ (altach wpy ol lang legal descnption) <br /> OWNER p ��GYIC, C0. 2� �'honclE-mail <br /> i <br /> Addmss (�$QQ � � � Ci�y/State/Zip e <br /> CONTRACTOR � L 8 I Lic.# * <br /> a o cta azi <br /> Address «�000 /VE t t � .SU 0 PhonclEmail <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT 0.L�� -tOryn <br /> •ae PhonelE-mail a� �9� '�tz3 <br /> BUILDING PERMIT APPLICATION coNrRACT PRice oF WORK Y600 <br /> ' HEAT SOURCE: <br /> Existing Use of Building . � <br /> � <br /> Proposed Use of Building /�/�Ge •�L-G•1 Gas_ Eier.tnc__ Other_ <br /> Building type: _Single Family _Duplex_Townhouse _Mulli-Family �Commercial <br /> Type of projecC �New �Addition _Remodel _Repair_T.L_Sign_Sprinkler_Demolilion_Change of Use <br /> DeSCfipii0n of Wofk(addilional space provided on fhe backJ: <br /> Relocc�te- e.x�st'lr� n+onuna.e-ni' sou�th ac.eoss d,t�utway �a �n.stall n.e� <br /> mo�.u�ntie.n.t tn. Sa,m� pic�.Ge� �s pra�io�.�.s s;o�Yl <br /> Have you started working without a permit? _YES �NO <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Typa of ProJect: _New_Addn _Alteration_Repair Type of Project: _New_Addn _Alteratlon_Repalr <br /> Show Number(p)ol Ilxtures Show Number(#)0/flxtures <br /> I A/C—air handling units I Toilet <br /> � forced air systems I Bathtub <br /> i Gas piping I Lavatory(wash basin) <br /> � Water heater I Shower <br /> � Gas freplace I Kitchen sink 8 disposal <br /> I Gas range I Dishwasher <br /> I Clothes dryer 'i Clothes washer <br /> i Range hood I W ater heater <br /> Exhaust fan � Sink(service/bar/mop/etc.) <br /> Heat pump � Backllow preventer <br /> Unil heater I Urinal <br /> Boiler � Drinkin Founlain <br /> Refrigeration Floor drain <br /> � Wo�ds�o�e ' Grcase tra �, <br /> I Ducting '� Roof drains <br /> � Other Medical Gas <br /> SPRINKLER/ SUPPRESSION SYSTEM I Other: <br /> �� Number of Hcads � Other: <br /> I�ereby cenify ihat I have read and examined lhis applica�ion and know the same to be Ime and correcl All provisions of laws and ordinances goveming <br /> Ihis type ol vmrk vnll be complied wi�h wheiher specifed herein or noL The graniing of a permit tloes not presume lo give authon�y to violale or cancel <br /> Ihe provision of any othe�state o�local law regulaling conslruction or Uie perlormance of constmclion.That I am authnrized by the ovmer ol Ihis property <br /> to Oedorm Ihe woik for whic applicalion is made and I compty wilh ihe Slale Contractors Ww 7827 RCW and 296200 WAC <br /> � �/ � <br /> O.�i�erl uthorizod Ag rt Signature Oate (Rovised 2/2071) <br /> 1IZ <br />