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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 />Lv1 `J J(IU <br />PROPERTY TAX <br />n tU V ULJ <br />P RMIT0 <br />i0 <br />li� <br />L Cu <br />LEGAL for new construction Short Plat/subt ivision Lot No (attach copy of long legal description) <br />OWNER UC \ Ivy C.Ed <br />Phane/E-mail <br />Address \S\S "�,5 " .51'J Lek sov <br />A -7 <br />City/Slale/lip i �jtreA,,(� vi1A- ckra' z`�S <br />APPLICANT:_Owner Owner's Agent `,Contractor Contractor's Agent 7onant lmu+t powaawner aramem nom ine o+.wmaa.onno»rp.cel <br />CONTRACTOR _ �, IWS-er^ -l"t �'`.` t `r "i it1 <br />L BLII Licc ff COE Bus. Lic. p c• <br />l <br />Address .��>\!J `\ hN4`L— At1e ATF L41L \i.\Jill(o '"ia� Y2. Phone/Email Ej 25.4Y 1' VL'(p <br />TENANT BUSINESS NAME <br />ONTACT FOR PERMIT <br />5eccC.0 <br />1J� <br />[hanelIE-madC Ii LC a^1 <br />BUILDING PERMIT APPLICATION <br />CONTRACT PRICE OF WORK 2,> 1, U tl'1 <br />Existing Use of Budding Sy t %H HEAT SOURCE <br />Proposed Use of Building �a rK 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 (additional space pmvkyed on the back) : <br />iI it Spit 1 Ac L. #A r vc%i gaii civi cor,ri-ck -Eo <br />I'(`,i 12 <br />MECHANICAL PERMIT APPLICATION <br />PLUMBING PERMIT APPLICATION <br />Typo of Protect: Now _Addn _Alteration _Repair <br />Typo of Project: _Now _Addn _Alteration _Repair <br />Show Number a of fixtures <br />Show Number a of fixtures <br />1 <br />A/C —air handling units <br />Toilet <br />Forced airs stems <br />Bathtub <br />Gas pli <br />Lavatory wash basin <br />Water heater <br />Shower <br />Gas fireplace <br />Kitchen sink 8 disposal <br />Gas ran a <br />Dishwasher <br />Clothes dryer <br />Clothes washer <br />Range hood <br />Water heater <br />Exhaust fan <br />Sink servicelbarlmo /etc <br />Heal pump <br />Backflow preventer <br />Unit heater <br />Unnal - <br />Boiler <br />Drinking Fountain <br />Refrigeration <br />Floor drain <br />Woodstove <br />Grease trap <br />Ducting <br />Roof drains <br />Other ii <br />F Medical Gas <br />SPRINKLER I SUPPRESSION SYSTEM <br />Other <br />Number of Heads <br />Other. <br />I hereby cerldy, that I have read and examined this application and know the alma to be tri» and coned_ AN provmons of laws and ordinances governing this type of work will be complied <br />with whether spe elied heroin or not The grinding of a permit dote not presume to give sul"Y to vidals or concel the pros of any other state or local Lew re2uiabng coastrudion <br />That I a Canted by the own this property to Perform the work for which application Is made and I comply with the State Contractors Law to 27 RC W and 296 200A WAC <br />(Revised tYlgf2l <br />Oweerl utho Agent Signature Dale <br />