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01/17/2012 TUC 15104 PAX m001!00z <br />PERMIT APPLICATION <br />BUILDING/MECHANICAUPLI.JMBING/SIGN/SPRINKLER/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 />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM I ` I R /' <br />SITE ADDRESS: <br />- 3r Sri- 56 <br />PROPEflTYTAXa <br />3�t29ooaootcoo <br />Mtia <br />�� U �, <br />LEGAL for newconstmaion'. Shen PlaUsubdlNsion LoI NO_ (attach copy.•o1f long Nepal deuxiption) <br />OWNER <br />�Q- <br />' OZ 0 <br />Phone/E.mail L • <br />Address ��3'`St- SIC <br />�y�7• <br />(J <br />City/SlatdLP �•vP—re+A— (s20 <br />CONTRACTOR 6 M&A %hq ad A CL <br />& I Lic p 6SF <br />Addrose gA5 S.S qRlaq Phone/Emall ZOIp,-} <br />TENANT BUSINESS NAME <br />CONTACT FOR PERMIT <br />JGSv— ►-ZFTmloet.ILP l' <br />Phone/Finall C3 QLp • — <br />BUILDING PERMIT APPLICATION <br />CONTRACT PRICE OF WORK <br />Existing Use of Building HEAT SOURCE: <br />Proposed Use of Building �77Gas_y Eleatic Other <br />Building type: �( Single Family _ Duplex _Townhouse _ Multi -Family _ Commercial <br />Typo of projecL _ New _ Addition _ Remodel _ Repair _ T.I. _ Sign _Sprinkler _Demoliuon_Chango of Use <br />Description of Work (edddiol..:paceprovided on lho back) * \ h5kt% 11 9Q3 JPArAcLi l--P-nno,4 j <br />rn�18ouHo-VoMoA,$b°!o11+0Ooo6-u) reQlacq J;V r-�t{fQ <br />Have you started working without a permit? _YES 9 NO <br />MECHANICAL PERMIT APPLICATION <br />PLUMBING PERMIT APPLICATION <br />Typo of Project: _New_Addn I"Afforatlon _Repair <br />Show Number (a) of fixtures <br />Type of Project: _Now _Addn _Alteration _Repair <br />Show Number ) of fixtures <br />!VC — air handling units <br />Toilet <br />Forced airs stems <br />Bathtub <br />Gas pipinq <br />Lavatory wash basin <br />Water heater <br />Shower <br />Gas fire lace <br />Kllchen sink 6 dis osal <br />Gas range <br />Dishwasher <br />Clothes dryer <br />Clothes washer <br />Range hood <br />Water heater <br />Exhaust fan <br />Sink service/bar/rno /etc. <br />Heal pump <br />Backfiow, proventer <br />f <br />Unit heater <br />Urinal <br />Boller <br />Drinking Fountain <br />- <br />Refri erallon <br />Floor drain <br />Woodstove <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 aNfy, that I have read and examined this appllcaLon and know the "me to be trot and correct All provisions of lawn and ordinances governing <br />this type of work will be complied with whether specified heroin or not. The granting of a permit does not presume to give authority to violate Or rarcal <br />the provision of any other state Or local law regulating construction or the performance of construction . That 1 am sudh riztd by the owner of this property <br />to perform the wo for application Is made and I comply with me State Contractors Lew 18.21 RCW and 296.200 WAC <br />gont Signature Oate (Rewind N2011) <br />