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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 />SITE ADDRESS: O� -r/f <br />P}p?ERjjv.i <br />(x) <br /># O� D <br />P 1 IT • -O <br />LEGAL lot new construction Short Plagsubd,vision _// <br />v 1 oll No (anach copy of llong legal descfiplion) <br />OWNER / AC; <br />PhonelEman <br />✓ "Aa9` (wv <br />Addicss <br />0 <br />edylStatelzip <br />tvlfet/9- <br />APPLICANT: 74Owner _I Agent _Contractor _Contraclors Agent <br />Tenant lmue pmvda alarm orcoruent rtom Die owrrrroaa wpanma sestet <br />rOwners <br />CONTRACTOR qne A/ <br />State Lic # <br />City Bus. Lic is <br />AddressP-In. m( / 7 <br />Pnone—IZ-I <br />TENANT BUSINESS NAME <br />CONTACT FOR PERMIT <br />FhonplE mail vrdokycv�lwe <br />BUILDING PERMIT APPLICATION <br />CONTRACT PRICE OF WORK <br />Existing Use of Building -- _ <br />Proposed Use of Building r`/EW 5//VL'7AC147H[�Y <br />Building type: Single Family _ Duplex _Townhouse `Multi -Family _Commercial <br />Type of project New Addition Remodel Repair T I. Sin <br />HEAT,jJQURCE <br />Ges_ Electric Other_ <br />_Sprinkler Demohbon__Chan a of Use <br />DESCRIPTION OF WORK (additional space provided on the back) <br />0c)J6J u,C7' al€`w F-6,O,6oCt <br />YOti9Lrir <br />- /N�0 <br />�jE eOOM A41() �)`��� <br />MECHANICAL PERMIT APPLICATION <br />PLUMBING PERMIT APPLICATION <br />Type of Project: Now _Adds _Alteration _Repair <br />Show Number (#) or fixtures <br />Typo of Project: _New _Addn _Alteration _Repair <br />Show Number (a) or fixtures <br />A/C - air handling units <br />3 Toilet <br />I It Forced airs stems <br />I Bathtub <br />Gas piping <br />21 La log wash basin <br />Water heater <br />Shower <br />Gas fireplace <br />I Kitchen sink & disposal _ <br />Gas ran e <br />i Dishwasher <br />Clothes dryer <br />Clothes washer <br />Range hood <br />eater <br />I Li Exnausl fan <br />Sink service/tar/mo letc ) <br />Heal pump <br />Backgnw preventer <br />Unit heater <br />Urinal <br />Boiler <br />Drinking Fountain <br />Refrigeration <br />Floor drain <br />Woodstove <br />_ <br />Grease trap <br />Ducting <br />Roof drains <br />Other _ <br />Medical Gas <br />SPRINKLER, <br />SUPPRESSION SYSTEM <br />Other <br />Number of Heads <br />Other <br />I hereby cee y Ihai I have read and esamined this application and know the same to be Irue and ranee All provisions of laws and otdmances governing this type of work wl be comp;ed <br />with whether speeded herein or not the granting of a permit does not presume togNe autnomy to violate of cancel me provision of any other state w li law regulating cons"" <br />That lam outhallred by the owmel of tlds properly to perform the work for which application is made and I comply v h the Slate ConuaHas Low 19 21 RC W and 296 200A WAC <br />Owner arfdAgabt Signatu Date (Revised 3/7e13) <br />