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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 - www.everettwap t 5 _ // <br />nn, ,rwnnua ARE AcecaTFn FROM R AM TO 4 PM <br />SITE ADDRESS: <br />PROPERTY TAX x <br />PER Ta <br />/S,�O 7ao P . 5� <br />o / one) 003A0 <br />LEGAL for now cons.ruction: Short Plath ubdivlslon M041C r/31 sL Lot No. 3 (attach copy of long legal description) <br />OWNER L-7 /- C� - K 2Cy <br />PhonetE-mall k 5 r/1 y 3 (g2 0.� 0,7 • C U/YI <br />Address /Y-Q'9 %�n� r • 5E <br />Caylstate2lp C r Vew-elf WA 99203 <br />CONTRACTOR 6rf,0W4-e%Jf LLC L d 1 Lic. 0 <br />Pa" i+IC et.J Phone/Email <br />Address <br />TENANT BUSINESS NAME %2/?91/L <br />CON ACT FOR PERMIT <br />Phone/Email <br />BUILDING PERMIT APPLICATION <br />ICONTRACT PRICE OF WORK 2 <br />Existing Use of Building ,4/0f1 C- 5111 FfyM/L Y HEAT SOURCE. <br />Proposed Use of Building S/N64C F/1M/LY HOMF Gas Elecldc Other <br />Building type: X Single Family _ Duplex _Townhouse _ Multi -Family _ Commercial <br />Type of project: �g_ New _ Addition _ Remodel _ Repair _ T.I. _ Sign _Sprinkler _Demolition_Change of Use <br />Description of Work (additional space provided on the back): <br />Have you started working without a permit? _YES k NO <br />MECHANICAL PERMIT APPLICATION <br />PLUMBING PERMIT APPLICATION <br />Type of Project: _Now_Addn _Alteration _Repair <br />Typo of Project: Now _Addn _Alteration _Repair <br />Show Number(#) or fixtures <br />Show Numbert'i or fixtures <br />AIC - air handlin unite <br />Toilet <br />Forced airs stems <br />Bathtub <br />Gas pipingLflvelo <br />wash basin <br />Water heater <br />Shower <br />Gas fireplace <br />L <br />Kitchen sink 8 disposal <br />Gas range <br />z <br />Dishwasher <br />2 <br />Clothes dryer <br />Z <br />Range hood <br />Z <br />Waller heater <br />Exhaust fan <br />Sink (ser left. <br />HeatpumpBackflow <br />fereVentero <br />revenler <br />Unit heater <br />Urinal <br />Boller <br />Orinkin Fountain <br />1 <br />Refrigeration <br />I <br />Floor drain <br />Woodstove <br />Grease trap <br />Ducting <br />Roof drains <br />Other <br />Medical Gas <br />SPRINKLER I SUPPRESSION SYSTEM <br />Othor: <br />Number of Heads <br />Other: <br />I hereby cemly that 1 have read 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 speclfied herein or not The granling of a pennh does not presume to give authority to violate or cancel <br />the provision of any other state or local law regulating construction rr the performance of construction. That I am authorized by the owner of this property <br />to perform the work for which application Is made/and 1 comply with the Slate Contractors Low 19.27 RCW and 296.200 WAC <br />(Revised 2ROtfJ <br />'awnerlAulhor) ed Agent Ig allure Vale <br />