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PERMIT APPLICATION <br />BUILDING/MECHANICAL/PLUMBING/SIGN/SPRINKLER EMOLITION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 Cedar St., Everett, WA 98201 425-257-8810 FAX 425-257-8857 www,everettwa.org <br />SITE ADDRESS: O L C <br />✓ <br />PROPERTY TAX it O <br />PE MIT 0 O — O <br />oq <br />LEGAL for new conslrUdion Short Plal/suubdiws,on Lot No _ (attach copy of lung legal description) <br />// <br />OWNER !j / F� <br />PhonelE-mailyf9.5 - 0C <br />Address toiti <br />Circ.;,late2lp �� 57Y �MES ,try /a l <br />APPLICANT: Own _Owner's Agent Contractor Contraclors Agerd Tenant host po<dea'liter or censem ltm lheowner Tn do woM1 nhie spYel <br />CONTRACTOR if i ABC <br />Slate Lic. # City Bus Lic # <br />,L�(..�SJ <br />Address ,0. o,( ( � Fa?, ./ / PhonelEmail j�t�(L <br />TENANT BUSINESS NAME <br />CONTACT FOR PERMIT <br />PhonelE-mall <br />BUILDING PERMIT APPLICATION <br />CONTRACT PRICE OF WORK <br />Existing Use of Budding HEAT SOURCE: <br />Proposed Use of Building Gas_ Electric_ Other — <br />Building type _ Single Family _ Duplex _Townhouse _ Multi -Family _ Commercial <br />Type of project: New Addition Remodel Repair T.I. Sign _Sprinkler Demolition Chan a of Use <br />DESCRIPTION OF WORK (adddlolral space provided on the back) <br />Z)fin7oiii(/5IJx�s1i�/� <br />MECHANICAL PERMIT APPLICATION <br />PLUMBING PERMIT APPLICATION <br />Typo of Project: _Now _Addn _Alteration _Repair <br />Show Number (0) or fixtures <br />Typo of Project; _New _Addn _Alteration _Repair <br />Show Number s) or fixtures <br />A(C - air handling units <br />Toilet <br />Forced an 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 heater <br />Exhaust tan <br />Sink servlcelbortmo )etc <br />Heat pump <br />BackRow preventer <br />Unit healer <br />Urinal <br />Boiler <br />Drinking Fountain <br />Refrigeration <br />Floor drain <br />Woodstove <br />Grease trap <br />Ducting <br />Roof drains <br />Other <br />Medical Gas <br />SPRINKLER <br />I SUPPRESSION SYSTEM <br />Other. <br />Number of Heads <br />Other: <br />' e1`7 <br />I hereby cedify that I have read and examined this appka'aon and know the same to be Ime and rnnect All to wsions of Jews ano oid'mances 0oveming this type of work wa be compl.ed <br />wth whether specified herein or not The granting of a permit does not presume to give avilli to violate or osocel the provisxxt of any other slate or local law ragutating cumWlVon <br />Thal 1 am suithi by the owner of this property to pen on the work for which application Is made end I comply wish the State Conlmdas low 1111 RC W and I" 200A WAC 1 I <br />x// <br />OwnerfAutho ob Agent Signature ate (Revised 312013) <br />