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PERMIT APPLICATION <br /> BUILDINGIMECHANICALIPLUMBINGISIGNISPRINKLERIDEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 Cedar St., Everett, WA 98201 -425-257-8810-FAX 425-257-8857-www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> SITE ADDRESS:yL 132 I^I ter 6T E, lt� P00 <br /> 4ROPERTY Tgf)01 oN O100 <br /> MITN -0I <br /> LEGAL for new construction Short PlaVsubdn is1W1 n h f!5- V 1 J `­Lol No 44 to (altach copyoflong legal description) <br /> OWNER O Phone/E-man dC'QI \ Ot] P <br /> Address .0 . O 1�04 Cdy/StatNlip `1,/ W t 0e- WA qg 2, 1D <br /> CONTRACTOR . L/8�I Lic p <br /> 1007, 41 117-5 <br /> Address (J Phone/Email <br /> TENANTBUSINESSNAME CONTA TFORPERMIT MICYI�I'e .hr15't�Y16eN <br /> hLrU .Nr Cil �7 <br /> Phone/E-mail � ' r <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK re- 1y S4 CL <br /> Existing Use of Building N I Pr HEAT SOURCE <br /> Proposed Use of Building Q q V 1-e X Gas Elactnc Other <br /> Building type. _Single Family Duplex_Townhouse _Multi-Family _Commercial ¢zySflS <br /> Type of project: )L New _Addition _Remodel _Repair_T.I._Sign_Sprinkler_Demolition_Change of Use <br /> Description Of Work(edddronel space provided on the beck): <br /> r 2(008 A C1 <br /> (!M1';dN(4- new d[OlfV 1304"DiF t641 SI�� 7gzX43 <br /> Have you started working with •t a permit? _YES _)�,_NO * Zg30LA <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> lypeof Project New_Addn _Alteration_Repair Typeof Projeeb 4Now_Addn _Altonstion_Repeir <br /> Show Number 0 of fixtures Show Number of fixtures <br /> AIC—air handling units Io Toilet <br /> Forced airs stems L4 Bathtub <br /> Gas piping Lavatory wash basin <br /> Water healer Shower <br /> Gas fireplace Kitchen sink 8 disposal <br /> Gas range Dishwasher <br /> Clothes dryer Clothes washer <br /> �:. <br /> Range hood Water heater <br /> Exhaust fan Sink service/bar/mo lett <br /> Heatum Backflow reventer <br /> Unit heater - ' r. Unnal <br /> Boiler Drinking Fountain <br /> Rein erabop Floor drain <br /> Woodstove Grease trap <br /> Dudm Roof drains <br /> Other Medical Gas <br /> SPRINKLER / SUPPRESSION SYSTEM Other <br /> 1 Number of Heads Other <br /> I hereby certity that I have read and examined this application and know the same to be true and coned All provisions of laws mW ordinances governing <br /> this type of work will be complied"In whether specified herein or not The granting of a permit does not presume to give authority to violate w cancel <br /> the provision of any other state or local low regulating construction or the performance of construction That I nm authorized by the owner of this property <br /> to perform the work for which application is made and I comply with lhe,State Cp ilreclors Lew 16 27 RCW and 296 200 WAC <br /> OwnedAuthorizcrlA'genlSignalur 3if/y]Jat�e �3 (Newsed2,1011) <br /> �12 <br />