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PERMIT APPLICATION <br /> BUILDING/MECHANICAL/PLUMBING/SIGN/SPRINKLER/DEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 Cedar St., Everett, WA 98201 425-257-8810 FAX 425-257.8857 vnvw.everettiNa org <br /> SITE ADDRESS: +h S C - 'P �- 1)� PROPERTY TAx R O 20 P MIT e - <br /> 13 Q60 <br /> LEGAL for new construction Shod Plat/suubbd,vis,on________G_ Lal No_ (attach copy of tong legal description) <br /> OWNER (�7y� \(� ,t�1,t,Na. i%1 Phone/E-mall �t2S-`t?A'70D.2 IQ0�0 WD1iV'Af 1 .CDM <br /> Address 1-1` V TW ST SG -EVe(et1 AA .y/,tate1zip e\jW W cl 2 3 <br /> APPLICANT: )(Owner _ OwbCYS AglOt Conlraelor Contractor's Agent _ Tenant lTwu WovMeaiererdtaumincm xewnrrnCa wonmeNtpxai <br /> CONTRACTOR uJ State Lic.R try Bus. Lic a <br /> Address Phone'E mad <br /> TFNANT BUSINESS NAME CONTACT FOR PERMIT <br /> OWh&Y <br /> Phone'[ <br /> -mail <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK� .14 3 11 — <br /> Existing Use of Budding 1.-f`t� Ci 1-I. 6\1 qk RxaW k vt HEAT SOURCE <br /> Proposed UseGff Ouilding Qy4 k fg`�t 4 Gas Electnc other <br /> Building tych Ingle Family _Duplex_Townhouse _Multi-Family _Commercial <br /> Type of project New X Addition Remodel Repair T.I. Sign S nnkler Demolition Chane of Use <br /> DESCRIPTION CFWORK(adddroralsp'acep`row_dedon . (Q1 . 6,% 'R301A / <br /> it nkT1 hoyYA0f-(ka, q1K.wr 0JAYOce I <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Typo of lerolecl: _New Addn _Alteration_Repair Typo of Project: _Now_K.Addn _Alteration_Repair <br /> Show Number(a)of fixtures Show Number(e)of fixtures <br /> 4 1 AIC-air handling units Toilet <br /> Forced airs stems Bathtub <br /> Gas piping Lavatory wash basin) <br /> Water heater Shower <br /> Cas fireplace Kitchen sink 8 disposal <br /> Gas ran a Dishwasher <br /> Clothes dryer Clothes washer <br /> Range hood <br /> Fahaust fan Sink(servlcalbarlmcilett <br /> Heat pump Backgow preventer <br /> Unit heater Urinal <br /> Boiler Drinking Fountain <br /> Rein erabon Floor drain <br /> Wo xlstova Grease trap <br /> Ducting Roof drains <br /> Omer _ Medical Gas <br /> SPRINKLER I SUPPRESSION SYSTEM Other <br /> Number or Heads Other. <br /> I hereby unify that I have wad and eaommed this application and Anon the game to be two and cmrtct AN pmvisons of laws and are trances governing this type of work wvt be complied <br /> weh whether specified herem or not The granting of a permit does not presume to give authority to rmlale or cancel the pavmon of any Other time d local law wgutrlling construction <br /> 1 uthwaed by the ovmer of this property to pedaml the work for Which apphcalwn B made and I comply"IT the State Cenbadas Lew 16 27 RC W and 796 700A WAC. <br /> wnef/A razed Agent Signature 0� Date ' �� (Revised 312013) <br />