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SERMIT APPLICATIO" <br />BUILDING/MECHANICAL/PLUMBINGISIGN/SPRINKLER/DEMOLITION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 Cedar St., Everett, WA 98201 425-257-8810 FAX 425-257-8857 www.everettwa.org <br />SITE ADDRESS: <br />�rq"�'` <br />PROPERTY TAX <br />a&o5 i oo. O t -700 <br />PERM/ IY <br />O?)L <br />copy of Icng legal description) <br />LEGAL for new construction: Short Plat/subdivision Lot No.rr <br />OWNER C FYD �A 1 e S <br />`_,/ � `"((dattta``ch <br />ail (tr)' S-csQ <br />Phon elE m) <br />Address "' F- <br />QIh1Stalo/Zip . ea, jl k <br />APPLICANT: Cvmer _Owner's Agent//1), Contractor _Contractor's Agent Tenant (must provide alerer oleanseri nom mo vxno, to do vox come spare) <br />CONTRACTOR <br />A( CQ . <br />/_+ <br />State Lic. lit L.( 40NV City Bus. Lic. # <br />Address a p r7 of Phone/Email — --7480 <br />TENANT BUSINESS NAME <br />' <br />"`� Y I U <br />CO,.N��T ++CT FOR PERMIT <br />Jessica-3crdan <br />PhonelE.mail SS i5� ✓hut <br />BUILDING PERMIT APPLICATION <br />CONTRACT PRICE OF WORK0 O <br />Existing Use of Building 1 _l - HEAT SOURCE: <br />.�7 <br />Proposed Use of Building IZ ,' *� I L Gas_ Electric_ Other_ <br />Building type: _ Single Family _Duplex _Townhouse —Multi-Family -Commercial <br />Type of project _ New _ Addition _ Remodel _ Repair YT.I. _ Sign _Sprinkler _Demolition_Change of Use <br />DESCRIPTION OF WORK (additional space provided on the back): I <br />a-Cn os( TT 4 N'mo I CoSWJ--h'C-`: <br />MECHANICAL PERMIT APPLICATION <br />PLUMBING PERMIT APPLICATION <br />Type of Project: _Now_Addn _Alteration _Repair <br />Show Number (a) of fixtures <br />Type of Project: _New_Addn _Alteration _Repair <br />Show Number(al) of fixtures <br />A/C — air handling units <br />Toilet <br />Forced air systems <br />Bathtub <br />I Gas piping <br />Lavatory (wash basin) <br />I Water heater <br />Shower <br />Gas fireplace <br />Kitchen sink & disposal <br />Gas range <br />Dishwasher <br />Clothes dryer <br />Clothes washer <br />Range hood <br />Water heater <br />Exhaust fan <br />Sink (service/bar/mopletc.) <br />I leat pump <br />Backilow, preventer <br />Unit heater <br />Urinal <br />Boiler <br />Drinking Fountain <br />Refrigeration <br />I <br />Floor drain <br />W oodslove <br />Grease trap <br />DZDucting <br />Roof drains <br />Other <br />Medical Gas <br />SPRINKLER <br />I SUPPRESSION SYSTEM <br />Other: <br />Number of Heads <br />Other: <br />Corsi <br />I hereby ceddy that I have read and examined this application and know the same to be true and correct. All provisions of laws and ordinances governing this type olwork will be complied <br />with whether specified herein or not. The granting of a pound does not presume Iogive authority to violate or cancel the provision of any other state" local law regulating comilmdion <br />That I am authorized by the owner of this properly to perform the wort, for which application is made and I comply win the State contractors Low 18.27 RCW and 206.200A WAC. <br />11NO// <br />Ow I uthor od Age analmo I D)l (Revised 3?013) <br />�12. <br />