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PERMIT APPLICATION <br /> BUILDINGIMECHANICALIPLUMBINGISIGNISPRINKLERIDEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 Cedar St., Everett, WA 98201 425-257-8810 FAX 425-257-8857 www.ev rettwaa,orgl <br /> SITE ADDRESS: PRO 'I RTY TAXA PUT R -(13 Z' <br /> s sty <br /> LEGAL for new construction: Short Plat/subdivision I-ot No (attach copy of long legal description) <br /> OWNER r Phone/E-mail ZJ � Jr"- !� Lf/2 <br /> Address 7 ° ,'slit S) t/ t city/Stalerzip <br /> APPLICANT:—owner _Owner's Agenl _Contractor _Conbactoi s Agent _Tenant lmu+lpm ae e�ercarawn+erd rrem me))owner ro ao»^'v�n aw+nK°I <br /> CONTRACTOR T✓A -64>-)04 1 111" y a(, State Lic.# _I ti Js. Lic.# <br /> Address/�o Cv.��-rv�elm- 1I Phone/Email ,? 6l- ao-J-7J'2 <br /> TENANT BUSINESS NAME --]CONTACT FOR PERMIT <br /> Phone/Email U- I�l <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE of WORK 3 <br /> HEAT SOURCE <br /> Existing Use of Building _ <br /> : <br /> Gas.. Electric Other <br /> Proposed Use of Building <br /> Building type: _Single Family _Duplex_Townhouse _Multi•Famlly _Commercial <br /> Type of roil ecl: New Addition Remodel Re air T.I. SI n Sprinkler Demolition Chane of Use <br /> DESCRIPTION OF WORK radddionaf apace provided on the back): <br /> e7:62- 'fjxAli <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type of Project: _Now_Addn _Alteration_Repair Typo o, reject: _Now_Addn _Alteration_Repair <br /> Show Number of fixtures Show Number(a)of Nxfurea <br /> A/C-air handlin1 units Toilet <br /> Forced airs stems Bathtub <br /> Oae i in <br /> Lavatory wash basin <br /> Water heater Shower <br /> Gas fire lace Kitchen sink&disposal <br /> Gas ran e L ,tiwasher <br /> Clothes dryer Clothes washer <br /> Ren a hoed Water heater <br /> Exhaust fan Sink(service/bar/mon/etc) <br /> Heel um Backflow reventer <br /> Unit heater Urinal <br /> Boiler Drinkin Fountain <br /> Refrigeration Floor drain <br /> Woodslove Grease trap <br /> Ducting Root drains <br /> Other Medical Gas <br /> SPRINKLER / SUPPRESSION SYSTEM Other: <br /> Number of Heads Other: <br /> I hereby cavity that I have read and examined this appltcatnin and know 14 some to be twe and toric.All provisions of laws and okirNnces governing this We of worn will be compiled <br /> wth whether specdied heren or not The granting o emnd does not presume to line suthmny to violate or Meet Na provision of any ether awe or local is*repulaing censtruchon <br /> That 1 em authonted b !r of Ihls pro y 10 pe the work for whv:h eppecatan Is made and 1 comply wah the State Contractors Law 1x.21 RCW alk 2"200A WAC. <br /> / l —� <br /> C <br /> (Revised 312013) <br /> Ow <br /> WA, it Agonl Signature Dale <br />