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PERMIT APPLICATION <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.org <br /> APPLICATIONS ARE ACCEPTED FROM a AM TO 4 PM I7 ✓/ <br /> SITEADDRESS: ce].O�J PROPERTY TAX# MI 10 _C�i7 <br /> '4 ST S E Emong <br /> LEGAL for new construction Short Plat/subdlvlslon Lot No._ (attach copy of long legal description) <br /> OWNERCN(Q\ k L Phane/E mal I- S-71' ► G9 Ch <br /> Addrefs 1•1 118%4RWCSeatA_U tleiktCity/Slate/ZO <br /> CONTRACTOR CC) e z LLC,7r III N 8 1 Lic.#µ:l <br /> t PhonnlEmail aGb-(�10 (o S 3 <br /> Address) u les - CONTACT FOR PERMIT <br /> TENANT BUSINESS NAME <br /> /I I-'e1 t 1l},"r f�11 i-I 1 I11 I PhonelE-mall <br /> i <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK <br /> HEAT SOURCE: <br /> Existing Use of Building <br /> Proposed Use of Building Gas Elednc Omer <br /> Building type: _Single Family _Duplex_Townhouse Multi-Family _Commercial <br /> Type of project: _New _Addition _Remodel _Repair_T.I._Sign_Sprinkler_Demolition_Change of Use <br /> Description of Work(additional space provided on the beck): Yre_�w- Ae!,`F f f a`t NS <br /> Have you started working without a permit? _YES _NO <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Typeot Project: _New_Adda _Alteration_Repair Typeol Project: ew_Addn of Rxfureation_Repair <br /> Show <br /> Show Number(a)of fixtures beret <br /> NC—air handlingunits <br /> Forced airs stems Bathtub <br /> Gas piping Lavatory wash basin <br /> Water heater Shower <br /> Gas fireplace Kitchen sink 6 disposal <br /> Dishwasher <br /> Gas range <br /> Clothesd er Clotheswasher <br /> Ran a hood star heater <br /> Exhauslfan Sink service/bar/mo lett. <br /> Heal pump Backillo Dreventer <br /> Unit heater Urinal <br /> Boiler Drinking Fountain <br /> Refrigeration Floor drain <br /> Woodstove Grease trap <br /> Ductin Roof drains <br /> Other Medical Gas <br /> SPRINKLER I SUPPRESSION SYSTEM Other: <br /> Number cl Heads Other: <br /> I hereby certify that I have read and examined this application and know the same to be true and correct.All provisions of laws and ordinances governing <br /> this type of work will be complied with whether specified herein or not.The granting of a permit does not presume to give authority to violate Of cancel <br /> the provision of any other state or local law regulating construction or the performance of Construction.That I am authorized by the owner of this property <br /> to perform the worts for which application I made and I comply with the State Contractors Law 19.27 RCW and 296.200 WAC <br /> Ow Dr/ uthodzed Agent 519naIM9 <br /> Date (Revised 7/2011) <br />