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PERMIT APPLICATION <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 />Aool Irerlii ARF ACCFPTFO FROM 8 AM TO 6 PM <br />SITE ADDRESS: Iwe <br />;1')00 1(6 . SW n- o <br />PROPERTY TAX p <br />P <br />MI1 0 - <br />L,� <br />LEGAL for new constru.:hon Short PleVsubdwiuion Lot No _ (anach copy of long legal desorption) <br />I <br />OWNER V Pa d I fN �` f Q i Q k <br />PMneIE•mail d S 3 3. — J S 1 <br />q r <br />Address / �, �/� r: ~:i^ , <br />CeyrSlale2lp l-Gvi VI �0�� E 'C �$Dy <br />APPLICANT: [Tuner ✓ (MrefSAgerl _ (,r t,a<Ir+ Comnctoes Agent Tenai...tr-oe•a.-wc'mnumtnanme ow,v'!o as wan nev spaul <br />CONTRACTOR 0 If- <br />L 6 1 Lit N C.`iE Bus Lic N <br />AAdrees Phdnr'E nail <br />TENANT BUSINESS NAME <br />CONTACT FOR PERMIT <br />Peon,-T mail <br />BUILDING PERMIT APPLICATION <br />CONTRACT PRICE OF WORK <br />Existing Use of Budding _ __..- _ . — HEAT SOURCE <br />Proposed Use of Building Gas Electric Olne, <br />Building type -_ Single Family _ Duplex _Townhouse _ Mulb-Family _ Commercial <br />Type of p,o ect New Addition Remodel Re air T 1 Son S nnkler Demolition Chan a of Use <br />DESCRIPTION OF WORK (adddonal apace picindedcrt the back) <br />---kyle'tit 0 0 �J 1A P o-C�( N 0V > e— <br />MECHANICAL PERMIT APPLICATION <br />PLUMBING PERMIT APPLICATION <br />Typo of Project: _New _Addn _Alteration _Repair <br />Show Number (#) of fixtures <br />Typo of Protect: _Now _Addn _Alteration _Repair <br />Show Number (a) of fixtues <br />A/C — air handling units <br />Todel <br />Forced au systems <br />Bathtub <br />Gas piping <br />Lavatory (wash basin) <br />Water heater <br />I Shower _ <br />_ <br />Gas fireplace <br />Kitchen sink S disposed <br />Gas range <br />Dishwasher <br />_ <br />Clothes dryer <br />Clothes washer <br />Rare hood <br />Water heater <br />Exhaust fan <br />Sink (serwcelbarfmo /etc <br />Heat pump <br />Backnow, preventer <br />Unit heater <br />Urinal <br />_ <br />Roder <br />Drinking Fountain <br />Refrigeration <br />Floor drain <br />Woodstove <br />Greasetrap <br />Ducting <br />Roof drains <br />OU,L.. _ <br />Medical Gas <br />SPRINKLER I SUPPRESSION SYSTEM <br />Other <br />Number of Heads <br />Other <br />I hereby wrtRy That I have read and asam ned this spp,Yatan and kaow the fame Ia be We and wood An pmaaions of taws and oNnanms gaveming ren type of work wv! bo wmptied <br />wet wnlfhe, specdled hems, or no The granting or a permit does not p@surne to fiN'e AutAwey, to wbitle or gnarl pie pmw3en of any other state or b 1law regulating wnstmction <br />That I am Whwped by in* owns' of this property to Pediam the wwk for whtdt apptcatnn is reside and I comph with In* Slate CWurafo,a law la T 7 RC W and 298 2e0A WAC <br />OwnerlAuthonied Agent signature Dale <br />(Revised WO12) <br />