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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 <br />www.everettwa.org <br />weeACCEPTEDFROMRAMTOAPM 4 — 1.o_1 % <br />PERMITS <br />SITE AD RE <br />PROPERTY TAX R <br />U� <br />`1 �S r <br />0031,20c, Poo �/ o <br />LEGAL for new construction. Short Plallsubdivision P,LfI 291 'D - CXY I Lot No. (attach copy of long legal description) <br />t 7- <br />PhoneIE-mail a1' S- Y.J. w.:c+rsP 6a4sl7t.L <br />OWNER <br />v J <br />Address 11 '5 SE 103 <br />CltylStatal2lp C, U3 <br />APPLICANT:_ Owner Owner's Agent Contractor Conlractor's Agent Tenant (must pro,,,h, e. pf o-om me p`er to aonhesrace) <br />CONTRACTOR (-LC- L lS l LiC. # 5L"S'C-* COE Bus. Lic. # <br />Address ISW6.L� ¢ .Sti- -;"R tl r. IVRN WI'�-I o17 Phone1Emal3 ir1-g3(q- <br />TENANT BUSINESS ME <br />CONTACT FOR PERMIT -Tvh h <br />14••�tC IU \sit. <br />1Phone/E-maslJ4V-GU-qJ4L(¢ <br />Le-. <br />SAS <br />BUILDING PERMIT APPLICATION <br />CONTRACT PRICE OF WORK <br />HEAT SOURCE: <br />Existing Use of Building <br />Proposed Use of Building ��'"� —ht� Gas Electric Other <br />Building type: X_ Single Family _ Duplex _Townhouse _ Multi -Family _ Commercial <br />f e of project New Addition Remodel Re air T.I. Sign S rinkler Demolition Change of Use <br />DESCRIPTION OF WORK (additional space providedon (he <br />Iback): <br />:s ukts`fA o T waE'L(� C� f b CtvL�C.�Aa-a .a,....ay T I�aEA21- /F IFrA"J� r IAA L- Ar`.. <br />t,�. <br />L iL(J•u �l J -L .r.0'- 1"'I r <br />Orna nwTa-cn^ .. U <br />.l <br />MECHANICAL PERMIT APPLICATION <br />PLUMBING PERMIT APPLICATION <br />Typo of Project; _Now _Addn _Alteration _Repair <br />Type of Project: _Now_Addn _Alteration _Repair <br />Show Number # of fixtures <br />Show Numberill of fixtures <br />A/C - air handling units <br />Toilet <br />Forced airs stems <br />Bathtub <br />Gas piping <br />Lavatory wash basin <br />Water heater <br />Shower <br />Gas Gre iscs <br />Kitchen sink & disposal <br />Gas range <br />Dishwasher <br />Clothes d er <br />Clothes washer <br />Ran a hood <br />Water heater <br />Exhaust fan <br />Sink servicelbar/mo /etc. <br />Heal pump <br />Backllow preventer <br />Unit heater <br />Urinal <br />Boller <br />Drank in Fountain <br />Refri eratlon <br />Floor drain <br />Woodstove <br />Grease trap <br />Ductin <br />Roof drains <br />Other <br />Medical Gas <br />SPRINKLER I SUPPRESSION SYSTEM <br />Other: <br />Number of Heads <br />Other: <br />I hereby costly that I have read and examined this application and know the some to be true aM correct. Ad provisions of laws and ordinances governing this type of wait will be complied <br />with whether specked herein or not. The granting of a perms does not presume to give suthady to voters or cancel the provision of any other state or local law regulating consthodion <br />That I am authowed by the owner at this property to perform the work for which gpplicatan is made and I oempq with the Slab Contradors Low is 27 RC W and 2e9 200A WAC. <br />Owner�od Agent Signature Date (Revised 62012) <br />�Ml <br />