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PERMIT APPLICATION <br />BUILDING/MECHANICAUPLUMB1NG/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 ACCEPTEU FROM 8 AM TO 4 PM <br />SITE ADDRESS: rg. <br />PrtOPERTy TAX <br />oo <br />MIT 0 _ DO <br />LEGAL for new condruellon: Short Plattsubdivisbn _Lot No _ (attach copy of long legal description) <br />OWNER Ire Lj — <br />.�••c�� o: <br />Phone/E mail 2 — 3 I/ I <br />AddrC33 /� 5 E <br />�yT�a). <br />City/Stalelzip fl tt 1 / Al 5 <br />APPLICANT:—XGwner _Owner's Agent _Crntractor Contractor's Agent Tenant l^enr.man m.ohemem hom rdinn«wee con weao¢el <br />CONTRACTOR m <br />er cofe6t. <br />L & I Lic. k COE Bus. Lie. N <br />Address a �N le NA Phone/Email <br />TENANT BUS <br />CONTACT FOR PERMIT L1.ZeC OwC-� S <br />�?z5- 3�/7- !c y3/o <br />Phone/E-mail Kf r <br />BUILDING PERMIT APPLICATION <br />1CONTRACT PRICE OF WORK <br />Existing Use of Building Iv t=U-) S-- 1C) HEAT SOURCE: <br />Proposed Use of Building d'5 Oh _ Gas Electric Other <br />Building type: _Single Family _ Duplex __Townhouse _Multi -Family _Commercial <br />Type of project: New Addition Remodel Re elr T.I. Sin S rinkler Oemotition Change of Use <br />DESCRIPTION OF WORK (additional space provided on the back): <br />&U 14 5hdp lkN n 64% it�ill cr fx--,- 6�7 V-'reVty <br />MECHANICAL PERMIT APPLICATION <br />PLUMBING PERMIT APPLICATION <br />Typeo Pro)ect: _Now_Addn _Alteration _Repair <br />Show Number a of fixtures <br />Type I rojecl: _New_Addn _Alteration_Repair <br />Show Number a of Natures <br />A/C — air handling units <br />Toilet <br />Forced airs stems <br />Bathtub <br />Gas piping <br />Lavatory wash basin <br />Water healer <br />Shower <br />Gas fireplace <br />Kitchen sink & disposal <br />Gas range <br />Dishwasher <br />Clothes dryer <br />Clothes washer <br />Range hood <br />Water heater <br />�Exhpust fan <br />ink servicabarfmo /etc. <br />Hatift pump <br />BAckfichfir preventer <br />Unit afar <br />Urinik <br />Boller <br />DrinkindTountain <br />Rel Brat <br />Floor drain <br />Woodstove <br />Grease tra <br />DucBn <br />Roof drains <br />Other <br />Medical Gas <br />SPRINKLER <br />/ SUPPRESSIO SYSTEM <br />Other: <br />Number of Heads <br />Other: <br />hereby cei@y met I have reed and examned this application and Mnpx the same to be true and carted. AM provebnr of Ixnx and ordnenror govemNg NN type o ork MI be compiled <br />wrhwbenienpecNed herehornot. TM granangofa peeildoes not`��msfume to and eWhomy to Whale or cera:eltiv proNrbn of any oNer dale ataat low repu aconstnxhon <br />That I em euthodred by the miner of this pmo , to podarm the work MaMNch aPpkcnhon is made and I compy wlh the State Contractor- taw te37 RCW end 2aG g A WAC. <br />Owr�r/AWho ed Agent Signature Datato <br />(Revised e7012) 1 <br />FZ <br />