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PERMIT APPLICATION <br /> BUILDING[MECHANICALIPLUMBINGISIGNIS PRINK LERIDEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> t 3200 Cedar St., Everett, WA 98201 425-257-8810 FAX 425.257-8857 www.everett O or /y <br /> SITC ADDRESS: 11C_I PROPERTY TAX b PE; I a ID_U01 <br /> LEGAL for new construction short Piausuhewr)von Lot No (atlach copyofmng regal descriptmn) <br /> OWNER (?101 Qn) "1 PhonelE-mail �� )Z.�,r_ E�I' (��p�1'�T,s <br /> Address 13Zo -1 a tq JJ fw' Cdy/Slall ip 6 1:v41J ll 0 (�9 <br /> APPLICANT: —Owner _ Owner's AgentCnontr-actor _Conbaclor's Agent Tenanl(must ia*!ler or cansontroa one owner to wwoA nme+paw) <br /> CONTRACTOR — N /AT ) Stale tic # 772-1 a ° 10 VCity Bus Lriicc^'NP <br /> Address X00 If (,ON MectEiiiL'1:t-') 10 1 <br /> /j wo L f'honetEma.l (.J <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT <br /> PhmtetGma1 C+4-0L 0%" '/ <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK 00— _ <br /> Lxisbng Use of Building 0 _ _ HEAT SOURCE. <br /> Proposed Use of Building ',as Electric Other <br /> Budding type _Single Family _Duplex_Townhouse _Mul -Family _Commercial <br /> Type of project New Addition Remodel Re air J. Sin Sprinkler Demolition Chen a of Use <br /> DESCRIPTION OF WORK(additional space prowderdon the back) <br /> /1wLi9r,� 4Li(a oi- <br /> 404 <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type of Project: _New_Addn _Alteration_Repair Type of Project: _Now_Addn ,Alteration_Repair <br /> Show Number(e)of fixtures Show Number(a)o/Fixtures <br /> AIC–air handling units Toilet <br /> Forced airs stems Bathtub <br /> Gas piping Lavatory(wash basin) <br /> Water heater Shower <br /> Gas fireplace Kitchen sink 8 disposal <br /> Gas range Dishwasher <br /> Clothes dryer Clothes washer <br /> Range hoed Water heater <br /> Exhaust fan Sink(service/bar/mop/etc <br /> Most pump Backnow proventer <br /> Unit heater Urinal <br /> _ Boder Drinking Fountain <br /> Refrigeration Floor drain <br /> Woodstove Grease trap <br /> _ DucllngRootdralns <br /> Other Medical Gas <br /> SPRINKLER I SUPPRESSION SYSTEM Olher <br /> Number of Heads Other. <br /> I hereby cendy that I have lead and examined this applxaimn And know the same to be Imo and correct Al provisions of laws and ordinances governing this type of work win be compsed <br /> wah whelMr speufoed harem or not The rtrantmg nl a prr does n pesume to give authority to violate or cancer me provnron of any other sate or Neat law reguleling construction <br /> That 1 Am nmhonted b / r ar this/prupeny on <br /> nim the vier ,whah apportion is made and I rci with the state contredors t aw 1e 27 RCW and 290?00A WAC. <br /> Owner/Authorized Agent signature Dal. (Ransed�qO/J) <br />