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PERMIT APPLICATION <br />BUILDING/MECHANICAL/PLUMBING/SIGN/SPRINKLER/DEMOLITION <br />CITY OF EVERETT PERMIT SERVICES <br />Z00 Cedar St., Everett, WA 98201 425-257-8810 FAX 425-257-8857 www.everettwa.org <br />nor CAT!ONS ARP ACCFPTFD FROM 8 AM TO 4 PM <br />SITE ADDRESS-,{, <br />_Vr- <br />RPETYTA%# <br />PERMIT# <br />Zl Dc5LX) i <br />LEGAL for new constructions Short PI.Vsubdivision _Lot No'. (attach copy or long legal description) <br />OWNERDO <br />--7F <br />I_ <br />r-( <br />PhonelE-mail `J 30 - 0 <br />Address C✓ 0 / h S l� G <br />City/Stale/Zip <br />v-eL ,`I <br />APPLICANT:_ Owner --owner's Agent Contractor Contractor's Agent Tenant(muslprvvieeelercar afconsenllrom Pe caner to OowarkmOe Spam) <br />CONTRACTOR �-Q �� <br />L & I Lic. # COE Bus. Lic. # <br />1 <br />Address I 1^ �L'�C� Y S V( <br />I "(b <br />Phone/Email ��(-(�. L j 1 1 <br />TENANT BUSINESS NAMIc <br />CONTACT FOR PERMIT <br />Phone/E-mail _ <br />CONTRACT PRICE OF WORK Wr <br />BUILDING PERMIT APPLICATION <br />Existing Use of Building d , .0 HEAT SOURCE: <br />Proposed Use of Building *Fv- Iy ew Gas Electric_ Other__ <br />Building type: _ Single Family _ Duplex _Townhouse _ Multi -Family _ Commercial <br />Type of project _ New _ Addition _ Remodel _ Repair _ T.I. _ Sign _Sprinkler / Demolition_ Change of Use <br />DESCRIPTION OF WORK (additional space provided on the back): <br />s�R in�us be v-eMo4o <br />lsl� <br />MECHANICAL PERMIT APPLICATION <br />PLUMBING PERMIT APPLICATION <br />Type of Project: _New_Addn —Alteration —Repair <br />Show Number (#) of fixtures <br />Type of Project: _New_Addn __.Alteration _Repair <br />Show Number (#) of fixtures <br />A/C - air handling units <br />Toilet <br />Forced airs stems <br />Bathtub <br />Gas piping <br />Water healer <br />( <br />Lavatory (wash basin) <br />Shower <br />Gas fireplace <br />Kitchen sink 8 disposal <br />Gas range <br />Dishwasher <br />Clothes dryer <br />Clothes washer <br />Water heater <br />Range hood <br />Exhaust fan <br />Sink (se"icelbarlmopletc ) <br />Heat purrp <br />Backflow preventer <br />Unit heater <br />Urinal <br />Boiler <br />Refrigeration <br />Drinking Fountain <br />I Floor drain <br />Woodstove <br />I Grease trap <br />Ducting <br />Other <br />Roof drains <br />Medical Gas <br />Other: <br />SPRINKLER I SUPPRESSION SYSTEM <br />Number of Heads <br />Other: <br />I hereby teddy that I have read and examined Ins uppikabon and knew me some to be We and Correct. As prowlers of lawn and ordnances governing this type of wcrk will be compiled <br />with whether specified herein or not. The granting of a permit does not presume lit gtia authority to violate w cancel Cho provision of any other slate or local law regulating construction <br />That I am aulhon:ed by the owner of INS property to perform the work for which application is made and I comply with the Slate Contractors Law 1827 RCW and 296.200A WAC. <br />Mlnfno.{�., <br />Owner/Authorized Agent Signature Date <br />(Revised 612012) <br />Z <br />