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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.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />SITE ADDRESS: <br />O ZN-o STREE i S. C <br />PROPERTY TAX N <br />I OOL4 0 Zon000 120o <br />PERMIT 0 <br />G 0 ODS <br />LEGAL for new construction Short Plattsubdivision ___ Lot No _I Z (attach copy of long legal description) <br />OWNER gjCJJ&gD iiU 0TER•, <br />Phone/E-maiItk5)-11i),9r76 lwi454bQakll <br />Address SAME AS Slit <br />Gly/Slalellip EvE�TT W 20'� <br />APPLICANT: YOwner Owner's Agent Contractor _Conitactor's Agent __Tenanllm!: prc�,eeaicecr o!runsemhom u,a owror todoeonnien spool <br />CONTRACTOR <br />11.8 1 Lic Al COE Bus, Lic N <br />Address Phone/Email <br />TENANT BUSINESS NAME <br />CONTACT FOR PERMIT <br />Phone/E-mail <br />BUILDING PERMIT APPLICATION <br />CONTRACT PRICE OF WORK _ 3000 <br />Existing Usc of Building EO-4,11 HEAT SOURCE <br />Proposed Use of Budding Gas Elecmc Other_ <br />Building type )( Single Family _ Duplex _Townhouse _ Multi -Family _ Commercial <br />Type of project New _). Addition & Remodel Repair _ T 1. _ Sign _Sprinkler Demolition Change of Use <br />DESCRIPTION OF WORK (acidd,onat space provided on the back) <br />ODNVEes ?LvTIOrJ OF EXIST I f.1L, 'bEGK- AeEA 04-10 NEW rvtASTE12 BFor?"M t,01 <br />/ktJDjlloN OF t i it-JA5EF $AiLI f-)Tint RDdr?QWT OF EK(STIr.IV L7r-:1EW N� <br />MECHANICAL PERMIT APPLICATION <br />PLUMBING PERMIT APPLICATION <br />Typo of Prolecr: _New _Addn _Alteration _Repair <br />Show Number (#) of fixtures <br />Typo of Project: _Now _)LAddn _Alteration _Repair <br />Show Number(ill) or fixtures <br />A/C - an handling units <br />Toilet <br />Forced at systems <br />Bathtub <br />Gas piping <br />Lavatory (wash basin <br />Water heater <br />Shower <br />Gas fireplace <br />Kitchen sink 8 disposal <br />Gas range <br />Dishwasher <br />Clothes dryer <br />Clothes washer <br />Range hood <br />Water healer <br />Exhaust fan <br />Sink servicelbartmo lelc <br />Heat pump <br />Backnow preventer <br />Unit healer <br />Urinal <br />Boiler <br />Drinking Fountain <br />Refrigeration <br />Floor dram <br />Woodstove <br />Grease trio <br />Duding <br />Roof drains <br />Other _ <br />Medical Gas <br />SPRINKLER I SUPPRESSION SYSTEM <br />other <br />Number of Heads <br />Other <br />I hereby randy than I have read and Crammed this appiration and know the same to be Ime and Warm AN provisions of laws and ordinances governing This type of work will be compled <br />win whether speofed herein or not The granting of a permit does not presume Io give avihomy to mime of cancel the provivon al any other state or Wtll Law regutabng construction <br />That 1 am &Arced by the owner of this prppeny to perform the work for which application is made and I comply wnh the State contractors Law 16 27 PCW and 296 200A WAC <br />OWnorlAuthoriZed Agent STigniture Vale (Revised 6)2012) <br />