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PERMIT APPLICATION <br />BUILDING/MECHANICAL/PLUMBING/SIGN/SPRINKLER/DEMOLITION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 Cedar St., 1_verelt, WA 98201 - 425-257.8810 — FAX 425-257-8857 — www.eve. eltwa.or�g/� <br />,n A1,n.,e ADE ACc EpTPra FROM A AM TO A PM it -� 2 k? —// <br />SITE ADDRESS: r.t 51 �cL.[C3 <br />PROPERTY TA%N <br />PERMITN <br />14 <br />LEGAL for new construction: Shod PlaVaubdWision Lot No — (attach copy of long legal desciplion) <br />OWNER COC it-vr i <br />Phone/E-mail Z.S' ,Qi %U- 724 7 <br />Address $21l I�IAt becK PtUC <br />state2ip LUr ci 4 A 5 2U 5 <br />1 <br />CONTRACTOR <br />L 8 I Lie. # <br />Address - PhonelEmall <br />TENANT BUSINESS NAME <br />CONTACT FOR PERMIT AA A f- I- 3 e C(< <br />Phone/E-m,,,l .z S - e' 7C7.) , 1 1 <br />BUILDING PERMIT APPLICATION <br />CONTRACT PRICE OF WORK U <br />Existing Use of Building I- IZ HEAT SOURCE. <br />Proposed Use f Building I R Gas Elechle other <br />Budding type'. Single Family XDuplex _Townhouse _ Multi -Family _Commercial <br />Type of project: _New _Addition —Remodel V Repair_ T.I. _Sign _Sprinkler _Demolition_Changb of Use <br />New cover,^$ S <br />Description of Work (additional space provrdedon theback): t.1ew ?t.Ufnbrn5 . �i K4OR5 -(Mr <br />New CLn 1%A'v TUPS +lei/ <br />Have you started working wilhcut a permV _YES NO <br />MECHANICAL PERMIT APPLICATION <br />PLUMBING PERMIT APPLICATION <br />Type of Protect: _Now _Addn _Allo,atlon _Repair <br />rypo of Project: _Now_Addn _Alteration _Repair <br />Show Number (N of Cxfuroa <br />Show Number(N) Of fixfuroS <br />A/C - air handling units <br />I <br />Toilet <br />Forced airs stems <br />Bathtub <br />Gas piping <br />Lavatory wash basin <br />Water heater <br />Shower <br />Gas fire lace <br />, <br />Kitchen sink & disposal <br />Gas range <br />Dishwasher <br />_ <br />Clolhesd ar <br />Clothes washer <br />Ran a hood <br />Water heater <br />Exhaust fan <br />Sink servicelbar)mo /etc. <br />Heat pump <br />Backflow Preventer <br />Unit heater <br />Urinal <br />Boiler <br />Drinking Fountain <br />Refrigeration <br />Floor drain <br />Woodstove <br />Grease trap <br />Ducting <br />Rool drains <br />j <br />Other_ <br />Medical Gas <br />SPRINKLER I SUPPRESSION SYSTEM <br />Other: <br />Number of Heads <br />Other: <br />I hereby certify that I have road and examined this application and know the same to be true and correct. All provisions of laws and ordinances governing <br />this type of work will be complied with whether specified herein or not, The granting of a permit does not presume to give authority to violate or cancel <br />the provision of any other state rr local low regulating construction or the performance of construction. That I am authorized by the owner of this property <br />to perform the work for which gplakea0lm is made and I comply with the Stale Contractors Law 19.27 RCW and 298.200 WAC <br />(Revised Y10f f) <br />OwnerfAuthorizad Aganl signalling Vale <br />