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NERMIT APPLICATION <br /> BUII_DING/M�:CFIANICAL/PLUMBING/SIGN/SPRINKLER/DEMOLI'fION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 Cedar St., Everett, WA 98201 -425-257-8810—FAX 425-257-8857—www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> SITE ADDRE:SS: PROPERTY TA%p ERMIT X <br /> 1�7 12.�"t` D,(,i.� .$� 28o51R'��� a2�/Cv �D3 -Ov�I <br /> LEGAL for�rcv conslruction: Shod PI�t/su6division �—iyy5cc.._Lot No.J'1 (a'tach copy of long legal descriplion) <br /> OWNER (�l�nq/? N4'LI't(,l�'D � Z��o 27<�-V`"1 - -� � i�l AK.tc�n <br /> � ��' Phone/E-mail � ' �. L; <br /> Address ��U�S lQ/�,���`� L�S1 i" City/StalelZip n(f Gl.�..�-v �}- 373 <br /> CONTRACTOR L rlQ.i .Ii\CJ DI- L&I Lic.# LC N�N - � �� <br /> `��,) {2Ll �� 5T � zS�,5`1U '2�S <br /> Address \L(]�S � U(�i Phone/Email " , i � [ EICW . <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT y� „i p-tfC- "�� <br /> /Y�AQ "KE <br /> as3 S�l o uu'�� <br /> Phone/E-mail yy��/zi J KL• V�in15'�1 LK L L�NN/1Q�d6'19 <br /> BUILDING PERMIT APPLICATION CON7RACT aRICE oF WORK. _ ,i <br /> Exisling Use of Building �� IQ' _ HEAT SOURCE: �I <br /> ProposedUseofBuilding IU�L) s� �D��CnQ/1�P Gas Electric_ Olher_ <br /> Building lype: �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(addifional space provided on the back�: <br /> Const2uch`cn c� G �te.w S� r�.a�%c�i�� � � I 6 o�h�on � <br /> Have you started working wilhout a permit? _YES �NO <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERNAIT APPLICATION <br /> Typo of ProJect: �(,Now_Addn _Alteratlon_Repair Type of ProJoct:�Now_Addn _Alteration_Ropalr <br /> Show Number(q)o/lxtures Show Number(N)o/fixtures <br /> A/C-air handlin units Toilet <br /> Forced air s stems Bathtub <br /> Gas pipin Lavato (wash basin) <br /> Water heater Shower <br /> Gas fireplace Kitchen sink 8 disposal <br /> Gas range Dishwasher <br /> Clothes d er 1 Clothes washer <br /> Range hood Water heater <br /> Exhaust fan Sink(sen�icelbar/mop/etc.) <br /> Heat pump Backflow preventer <br /> Uni�heater Urinal <br /> Boiler Drinkin Fountain <br /> Refri eretion Floor drain <br /> Woodstove Grease trep <br /> Ductin Roof drains <br /> Other Medical Gas <br /> SPRINKLER / SUPPRESSION SYSTEM Other: <br /> Number of Heads Other. <br /> I hereby certify thal I have read and ezamined ihis applicalion and know the same to be true and correct.All provisions of laws and ordinances qoverning <br /> this type of work will be complied with whether specifed herein or nol.The granting of a pertnil does not presume to give aulhorily lo violate or wncel <br /> the provision of ny olher state or lo�al law regulaling conslruction or Ihe performance ot construction.Thal I am aulhorized by the owner of this propeAy <br /> lo perlorm ihe w 'ch a ' ation is made and I comply with the Stale Contractors Law 18.27 RCW and 296.200 WAC <br /> 3) 151 iZ <br /> OwnerlAuthor odAgon ro Dale (Revisetl2/LO11J <br /> 1/ <br /> z <br />