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• 0 <br />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 />/2-(9-/3 <br />SITE ADDRESS: <br />��01 i � r�l �G <br />PROPERTY TA%x <br />LEGAL for new construction Short Plallsuodrvlslon Lot No _ (attach copy of tong legal descnptmn) <br />OWNER <br />q '�Jp �t <br />Phone/Email — _ 2 Z I <br />/ <br />Address C)C) J aS7- 'j C- <br />^/ c <br />Gly/Stale/Ilia <br />APPLICANT: owner Owner's Agent _2Gontr.clor Contractor's Agent lenant(musip,oidoa...... uac=:ern hem No o.—ir m,+owon „inn.ra�) <br />CONTRACTOR 5AOK0Ms h T— A. <br />Stale Lic. If CityBus Lic. a <br />Address 7)-( vf_ <br />J <br />o N ")A Q 2-9 D Phone/Email Eiz S 32 S'00 <br />TENANT BUSINESS NAME <br />ONTACT FOR PERMIT <br />[hone/Fma.I <br />BUILDING PERMIT APPLICATION <br />CONTRACT PRICE OF WORK S 7 0,2 Z <br />Existing Use of Building , _— _ HEAT SOURCE: <br />Proposed Use of Building__ ___ Gas EteeInC_Other <br />Budding type. Single Family _ Duplex _Townhouse _ Multi -Family _ Commercial <br />Type of project _ New Addition Remodel ff it T.I. Sin Sprinkler _Demolition Chan a of Use <br />DESCRIPTION OF WORK (additional space provided on the back) <br />MECHANICAL PERMIT APPLICATION <br />PLUMBING PERMIT APPLICATION <br />Typo of Project _Now _Addn _Alteration _Repair <br />Show Number (a) of fixtures <br />Typo of Project. _New -_Addn _Alteration _. Repair <br />Show Number (a) of fixtures <br />A/C — air handling units <br />Toilet <br />Forced airs stems <br />Ralhlub <br />Gas piping <br />Lavatory wash basin) <br />Water heater <br />Shower <br />Gas fireplace <br />Kilchen sink 8 disposal <br />_ <br />Gas range <br />Dishwasher _ <br />Clothes dryer <br />Clothes washer <br />Range hood <br />Water heater <br />Exhaust fan <br />Sink (service/barlmo letc <br />Heal pump <br />RaclLgow prevener <br />Unit heater <br />Urinal <br />Boiler <br />Drinking Fountain <br />Refficietation <br />Floor drain <br />Woodstove <br />Grease trap <br />Ducting <br />Root drams <br />_ <br />Other------_— -- <br />ModicalGas <br />SPRINKLER <br />I SUPPRESSION SYSTEM <br />Other <br />Number of Heads <br />Other <br />I hereby ready that I have teed and eaammed ihn appl"1011 end snow the same 10 be true and correct All provisions of laws and ordmnnces governing IMs type of work wit be eomPked <br />with whether specdied herein or not The draining of a permit does nor prewme to give outhordy to ve lAfir Or cancel the provision of any other dale a local law legWating construction <br />That 1 am authoilted by the owner of INS proall la pederm the work for which application Is made and 1 comply with the Stale ConhK1011 Lax 1e 77 RC W and 796 700A WAC <br />_ Qe- 19 2013 <br />Owner/Authorlrod Agent Sign a Dale (Revised JdatJ) <br />