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*ERMIT APPLICATI09 <br /> BUILDING/MECHANICAI /PLUMBING/SIGN/SPRINKLER/DEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 Cedar St., Everett,INA 98201 425-257-8810 1 AX 425-257-8857 wwvv everettwa.org <br /> SITE ADDRESS: _ PROPfRTYrnxn PERMITS <br /> -oil <br /> LEGAL for new construction: Shod PlaVsubd,v,von Lot No. _ (attach copy of lorg legal descripl.on) <br /> OWNER 0,1AIZ( t &I-AJ1LJPhone[mail yZ 0/ - 2� <br /> Aderess Gtylstatelzip L ) tit ze%3 <br /> APPLICANT:—owner _Owners Agent _4con/tractor Contractor's Agent —Tenant 0v,pm,d,ser onwa.m I'm reoa.". wo�a+ <br /> artoa nrc space) <br /> CONTRACTOR T Slate Lic h Ev $ I Cil Bus Lic. M 7 <br /> Address Q !}-C-1 tL 1i'honeirEm4w <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT <br /> KE09hLO (4Z.&) 7-5-Z 3WfT <br /> Phone/E-mal 11,tept(v-V v;/I.ftw jab wa l <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK <br /> Existing Use of Bit HEAT SOURCE <br /> Proposed Usegf budding__ ._ Gas E•vctrl�_ Oil-er <br /> Buildingtype' Sing!eFamdy _L'up'eaIe:.nho�se _!.Iullrramily _Commercial <br /> Type of project. New Addition Remodel Repair T . Sin Sprinkler Demolition Chane of Use <br /> DESCRIPTION OF WORK(additional space provided on the back) <br /> Cll2tu&- our E'CISr/T � I, Lfrr�1 FFI ►1T�?L E Ota AC--to Ekf5T71J6645 kf4A � <br /> MECIIANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type of Project: _ New_Addn _Alteration_Repair Typo of Project: _Now_Addn _Alteration_Repalr <br /> Show Number(N)of fixtures Show NumberfX or flrrures <br /> NC-air handling units Toilet <br /> Forced airs stems Bathtub <br /> Gas pip:ng pipingLavatory(wash basin) <br /> Water heater Shower <br /> Gas lire lace Kitchen sink 8 disposal <br /> Gas ran a Dishwasher <br /> _ Clothes dryer Clothes washer <br /> _ Range hood aler heater <br /> _ Exhaust fan Sink servicel'barlmop/etc) <br /> _ Heat pump Backflow provenler <br /> Unit heater Urinal <br /> Boiler Drinking Fountain <br /> -- Refri :iation Floor drain <br /> Woods!ovo Grease Ira <br /> Other I Medical Gas <br /> SPRINKLER / SUPPRESSION SYSTEM Other. <br /> N,anbot ul H,,!i; Other: <br /> I hereby candy,that t ham read and eaahrnod this apillcation and anaw din fame to be true mad correct Aa provisons of Iowa and ordnances govehurg this typo or wod w.T be comps ed <br /> Nish whether speanrod herenunol The waribng of a retch does rat piervme to give aNhonty tovolateorcanutaro provhbn of uq other stale or tical lawregWalinq mmfrudion <br /> That l ansspiral abyneowner dvf/propeny�to prdprm Ina work tor which apptmelnn b made and l compN with the Slate ContudaLLaw to 2?RCW and 296200A w'AC. <br /> I a <br /> ownerlAulhoriaod Agent Signature Date. (Revised 317013) <br /> Iv <br />