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0 <br />PERMIT APPLICATION <br />BUILDINGIMECHANICALIPLUMBING/SIGN/SPRINKLERIDEMOLITION <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' m E'b 0 7/7A <br />/• C1 <br />PROPERTY TAX IsP <br />MIT ' O <br />LEGAL for nevr conitruclerl Snort Plallsublwision Lot No_ (attach copy of long legal descrtphon) <br />OWNER e-" <br />PhonetE mad �/, S- / 13- -v+le� <br />Add,css 06 QN,3 5T. E-VMC7T, 41 <br />C.ty/State2.P it <br />APPLICANT: Owner _Owners Agent Contractor __ contractor's Agent ___Tartan$,"•.;;•:.=m r�nnrormrowtnomde owroroeewan mtmsp«e$ <br />CONTRACTORo MARK llf �O <br />State Lic a * 0Y6 M CityBus. Llc a 0S/ ?8 <br />' Q -7 ,' <br />/�L{i a J�%N A(' ff PhOnlml�l aJ—Gi s _ J <br />Add'ess //M� .�, 5//ff4i W1) W L' S ('4n1 S 4 oW c� <br />TENANT BUSINESS NAME <br />CONTACT FOR PERMIT <br />fill (.W(4�PtJz <br />IPhonff'F .,,I va—56/-9, 2 A o S ' M .0 <br />BUILDING PERMIT APPLICATION <br />CONTRACT PRICE OF WORK <br />Existing Use of Building rl"h�-__ HEAT SOURCE <br />Proposed Use of Building �/hf Gas Electric_ Other <br />Building typeX Single Family _ Duplex _Townhouse _ Multi -Family _ Commercial <br />Type of project New _ Addition Remodel _ Repair T 1 Sign _Sprinkler Demolition Chan a of Use <br />DESCRIPTION OFWORK (admbonalspace provided onthe back$ <br />MECHANICAL PERMIT APPLICATION <br />PLUMBING PERMIT APPLICATION <br />Type of Project: __,New _Addn _Alteration _Repair <br />Show Number(II) of fix Lures <br />Type of Project: _New _Addn _Alteration _Repair <br />Show Number (s) of fixtures <br />A/C — air handling units <br />10IIe1 <br />Forced airs stems <br />Bathtub <br />Gas piping <br />Lavatory (wash basin) <br />Water heater <br />Shower <br />Gas fireplace <br />Kitchen sink 8 disposal <br />Gas range <br />Dishwasher <br />I <br />Clothes dryer <br />Clothes washer <br />Range hood <br />Water heater <br />Exhaust Ian <br />Sink (servicefbadmop/etc ) <br />Heat pump <br />Backgow preventer <br />Unit heater <br />Unnal <br />Boiler <br />Drinking fountain <br />Refrigeration <br />Floor drain <br />Woodslove <br />Grease trap <br />Ducting <br />Roof drains <br />Other <br />Medical Gas <br />SPRINKLER / SUPPRESSION SYSTEM <br />Other <br />Number of Heads <br />Other. <br />I hereby cents that I have raid and esemnied this apphcallon and snow the same to be true and correct At prowsvHs of laws and ordinances govern•ng this type of vvons will ire comPhed <br />Wh whether specified Wain w ml The gtamog of a pemd does rot presume to gke authwily to violate or cancer the provision of any other slate or local law iegutshng wnsiruclron <br />That I am eulhor4ed by the owner of thZp10 toperform the work for wnrcn apptiutton a made and I cempry win Inc slate edntradas law is Yr RCW and 296 700A WAC <br />3 -/040/ <br />Ownc IAu sorite AgcnI Signature Oale (Revised NOU) <br />