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PERMIT APPLICATION <br /> BUILDINGIMECHANICALIPLUMBINGISIGNIS PRI NKLER/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 /> SITE ADDRESS' <br /> 1 Pa OPERry tax a Mort <br /> �q—Tri Sw <br /> LEGAL for new conslrucbon Snort Playsubdwision____ Lol No __ _ latach copy of lorg legal desci phonl <br /> OWNER J-)(L--( �QCa) TOS Phone/E-mal <br /> Address C: — ' <br /> SL'- City/5tateop, <br /> APPLICANT: Owner Owners Agent ✓Contfactor Contractors Agent Tenant lmml pmr0earonei ofmment nom Ne owtx'r io as woA.n ilia span) <br /> CONTRACTOR State Lie.p L2 Cd Bus. Lic. R <br /> nnaress L1,(12 <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT <br /> PI'ene ra I <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK Ec.OLg72y <br /> Ealst.ng Use of Budding__ ___ _ _. . _ HEAT SOURCE. <br /> Proposed Use of BBuilding Gas ""E'ectn _cOther <br /> Building type ✓ Single Family _Duplex_Townhouse _Multi-Family _Commercial <br /> Type of project _ New Addition Remodel Repair T I Sign. __Sprinkler Demolition Chane of Use <br /> DESCRIPTION OF WORK(additions)space provided on the back) <br /> Int3'ro.y.•• 10v j UF' t=45 LrlSrieZr <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Typo of Protect _Naw_Addn _Alteration_Ropair Typo of Project: _New_Addn __Alteration__Roparr <br /> Show Number(e)of fixtures Show Number la)of fixfuras <br /> /C <br /> A —air handlingunits Toilet <br /> Forced airs stems Bathtub <br /> Gas piping Lavatory wash basin) <br /> Water healer Shower <br /> Gas fireplace Kitchen sink d disposal <br /> Gas range Dishwasher <br /> Clothes dryer Clothes washer <br /> Range hood Waller healer <br /> Exhaust fan Sink(servlce/barlmoplelc <br /> Heat pump Backflow proventer <br /> Unit heater Urinal <br /> Boder Dflnkl9 Feunl8la <br /> Ref( station Floor drain <br /> Woodslove Greal.e trap <br /> Ouctin Roof drains <br /> Other Medial Gas <br /> SPRINKLER I SUPPRESSION SYSTEM Other. <br /> Numbbr of Heads Othc r. <br /> I hereby candy life I have feed and examined this app"lion and know the same to be true and correct An provisions of taws and erdmorees governing this type of"A we be complied <br /> wan whether spetded herein or not The granl,ng of a perms does not presume to give authority to Willie Or cancel the provision of any other state or local law regulating Ooaslruction <br /> That 1 am aumorued by the owner Of this Properly to pedorm Ino work lot when appo0a0on is made and I comply with the State Contri,clora Law 18 27 RCW and gga 700A WAC <br /> Ow oriaed Agent Signature Date (Revised(?0171 <br />