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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 />11EPTED FROM a AY To A PIM <br />H I'YLIIrN 1 rV nJ n <br />PERMIT <br />SITE D E S: <br />LJ <br />P Z `jJ}, TY �a <br />L.A <br />I M No loch otxry of I(xig knal ik.KJlphtxri <br />LEGAL I�w{{new Slut/h1'laUwbini•,um___ _-__ --- <br />MTAtjC�SaKZ•® <br />��cnrrn��stn11x;hcxt <br />OWNERy-P-0'J W0'OV _s-Is-'Ue-S� PhhheJE-mmi 6-533-5009D <br />1 l I� Iv } <br />r. n;ln•�. r. CJ I'�1 V <br />C-RYISIaIMIiVShon It .fG V (M:7 • CID <br />'`A <br />iL D I t.►� l <br />CONTRACTORL�P'P-Q IN <br />L 81 Lic p <br />L <br />-1�Gi - dtO`{' <br />Ptxx l mail <br />A&v,, 4 1L l,3 U All o <br />TENANT BUSINESS NAME CONTACT FOR PERMIT riy A •ir(4) Q{�S <br />Tl✓� �l� �� xxv:n "'ad as - 01 - wt0 S , c oii <br />CONTRACT PRICE OF WORK �i (p �+ O v <br />BUILDING PERMIT APPLICATION f <br />Existing Use of Building 0���_. _ HEAT SOURCE <br />Proposed Use of Building UJA �'Q—f{ 0�f-- a4* Cy-- W% Llec OttOttw <br />Building type Single Family _ Duplex _Townhouse _ Multi -Family A Commercial <br />_ <br />Type of protect _ New _ Addition _ Remodel _ Repair )� T I _ Sign _Sprinkler _Demohtion_Change of Use <br />Description of Work (additional space provided on !her aac T <br />I ^ „ „ _ 1- <br />q 'o`t5 ,wv-1 rJ` � <br />3Q <br />LA, (0 v A) ; {-S C4A-eJ+;1jz'k - 2u'c lL <br />Have you started working without a permit? __YES 'V�-NO <br />MECHANICAL PERMIT APPLICATION <br />PLUMBING PERMIT APPLICATION <br />lypn of protect _ New _- _Addn __Alteration Repair <br />Type of Project _ New _Adds _Alteration Repair <br />Show Number (a) Of fixtures _ <br />Show Number (0) of fu rums <br />A/C - an handling units <br />Toilet <br />Forced airs stems <br />Bathtub <br />Lavatory (wash basin <br />Gas Piping <br />Water heater <br />Shower <br />Gas fireplaace <br />Kitchen sink & disposal <br />Gas range <br />Dishwasher <br />Clothes dryer <br />Clothes washer <br />Range hood <br />Water heater <br />Exhaust fan <br />Sink (servicelbar/m etc ) <br />Heal pump <br />Backnow ereventet <br />Unit heater <br />Urinal <br />- ler <br />Drinking Fountain <br />Ref ration <br />Floor dram <br />Woodsfove <br />Grease trio <br />DuctingRoof <br />drains <br />-.----._---- -- <br />Other_ <br />Medical Gas <br />SPRINKLER I SUPPRESSION SYSTEM <br />Other <br />Number of Heads <br />Other <br />I hweby c..tity that I now read and examined this aPdiratwn and know the same to be true and correct All provisions of laws end Vdihmtces govemmg <br />this type Of work will be Complied wth wine her SPeUfied herein or not The granting of a permit does not presume to give aulhordY to violate or Carxx!I <br />the provision of any other state IX I rat law regulating construction a the pertomtance of construction That I am aNhwzw by the career of this property <br />to pridorm Ih wak for wfiich a d alion rs made and I comply with the State Contraclors Law 18 21 RCW and 296 200 WAG <br />rVIA fweaC pJ�Is��11 <br />Owner Aut aO Agent Slg ature D to lRewsed 24gtt1 <br />