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PERMIT APPLICATI04N <br />BUILDING/MECHANICAL/PLUMBING/SIGNISPRINKLER/DEMOLITION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 Cedar St., Everett, WA 98201 425.257.8810 FAX 425-257.8857 www everettwa or <br />(4 -'. <br />SITE ADDRESS: s, <br />Ibis ,s - s, su <br />PROPERTY TAX s <br />P MIT a <br />LEGAL for new construe ron Short PlaVsubdivrslon — _Lot No _ Onadr copy ur long legal descnpbonl <br />OWNER t CI{fSC <br />vhone1mail HIS•//••51il- 7931 <br />Addruss 01 SP 5-1 d 1100 <br />Cdy)Slaley2rp SA J rAAJCtSLo, <br />APPLICANT:__. C,vner _Owners AgenlContractw __Contractor's Agent _Tenart,vn pc.wu.•-•act canaerrlrom Ns owrrnveu+.,, ro,ra;n <br />CONTRACTOR S J, Wad WMi1J <br />Stale Lic #6Dt1,11WQO'11 EG City Bus. Llc Al <br />Address 14ZI s1,.1 At_A:Kn S, Seahu:raA Sri1Dl PnenoiCma�1 ZOV�gSZ• 1177 <br />ICE SIhN1 <br />CONTACT FOR PER I <br />�IUA I <br />Phone C-ma: N I<• Sn 9• 7 `13 1 <br />BUILDING PERMIT APPLICATION <br />CONTRACT PRICE OF WORK <br />Existing Use of Building _ _ _ HEAT SOURCE <br />Proposed Use of Building Gas Electric Other_ _ <br />Budding type _ Single Family _ Duplex _Townhouse _ Multi -Family _ Commercial <br />i pe of project New Addition Remodel Repair T I Sign Sprinkler Demolition Chan a of Use <br />DESCRIPTION OF WORK (adddronalspace provided anthe back) <br />AnEz) Ntw ga0V fLD0(0 SIe+Y Dal I�-' <br />Cli?et d a 1uLu bRA1.J •t UCN, e J Z�ird•. ,� MRvi: Mer ,�• • <br />45t <br />MECHANICAL PERMIT APPLICATION <br />PLUMBING PERMIT APPLICATION <br />Type of Project _New _Addn _Alleratlon _Repau <br />Show Number (a) of fixtures <br />Type of Project _New _AddnAlteration _Repair <br />Show Number(0) of fixtures <br />NC -air handhn units <br />Toilet <br />Forced au systems <br />Bathtub <br />_ <br />Gas piping <br />Lavatory(wash basin) <br />_ <br />Water healer <br />Shower <br />Gas fireplace <br />Kitchen sink 8 43 sts 0s it <br />Gas range <br />Dishwasher <br />Clothes dryer <br />Clothes washer <br />Range hood <br />Water heater <br />Exhaust fan <br />Sink service/bar/mo /etc <br />Heal pumpBackaow <br />preventer (inside bld <br />Unit healer <br />Urinal <br />_ <br />Boller <br />Drinking Founlain <br />Refn erahon <br />Floor drain <br />Woodslove <br />Grease Ira <br />DuctingRoof <br />drains <br />Other— <br />MediLal Gas <br />SPRINKLER I SUPPRESSION SYSTEM <br />Other eAiM yclir.v9 Olt"" <br />Number of Heads <br />Other. J N= Fsoe. • M1c <br />J1 <br />'.) <br />I hereby cendy that I have rend and examined this application and know me same to be true and correct All provisions of laws ens ordinances governing this type of won w l be compted <br />with whether specftd herein or not The graining of a pemrA does not presume to give tlmhomy to violate or cancel the prnwslon of any other are!e ar local law regulating Construclon <br />That I am out rented by the owner of th to perform the wen, for which ap/Wcaton a male and I Comply Mh the State Conbactore Lew 10 27 RCW and 29e 200A WAC <br />N� Vies- <br />wner ul orize Agent Signature — ale (Revised 412015) <br />