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PERMIT APPLICATION <br /> BUILDING/MECHANICAL/PLUMBING/SIGN/SPRINKLER/DEMOL.ITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 Cedar St Everett, WA 98201 - 425-257-8810- FAX 425-257-8857-www e've/rettwa org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM �I -a 7 `/Z <br /> PROPCR7\'TAX x PERMIT a <br /> SITE ADDRESS: \ \o pal„ Oc_S 11 DLVC, Clue- � •' � LI` <br /> LEGAL for new constnuctlon Shan t PlatsubdlVlston Lot No_-_ (anach wpy of brig legal description) <br /> OWNER T . 170'\'\\:n P(xxtctEmail <br /> A+J,vss \ \�0 �-j \j9 cnyrstate2,p S —' ' " T1 �; IoS K`I <br /> CONTRACTORVVeStM,�,C 0JJW L 81 Luc a <br /> PhwelEmad <br /> Address <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT <br /> I`ncnrJL mail •To.n. ...,1� s rl <I In_\-S.,'4(r /.,w <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK I <br /> 7 L <br /> Existing Use of Building G r N s \c-Ir _-- HEAT SOURCE: <br /> Proposed Use of Buildi g C O M ��J�' l \ wy T•a-•'n r• bas Electric Otter <br /> Buildingtype _Single Family _Duplex_Townhouse _Mulb-Family —Commercial <br /> Type of project: _New _Addition _Remodel _Repair_<-T.1.—sign_Sp M\err De`rtoliton_Change of Use <br /> Description of Work(additional space provided on the back): M`a Cl ll <br /> Have you started working without a permit? _YES NO <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Typeol Prolect.. _New_Addn —Alteration_Repair Typeol Project: _New_Addn _Alteration_Rrlxiir <br /> 560w Number of fixtures Show Number(e)or fixtures <br /> PJC-air handing units Toilet <br /> Forced airs stems Bathtub <br /> Gas i in LBVete wash beam <br /> Water heater Shower <br /> Gas fireplace Kitchen sink 8 dls al <br /> Gas range Dishwasher <br /> Clothes d er Clothes washer <br /> Range hood Water heater <br /> Exhaust fan Sin /mopletc <br /> Heat pump Backflow preventer <br /> Unit heater Unnal <br /> Boiler Drinking Fountain <br /> Refrigeration Floor drain <br /> Woodstove Grease it <br /> _ <br /> Ducting Root drama <br /> Other Medical Gas <br /> SPRINKLER I SUPPRESSION SYSTEM (Other: <br /> Number of Heads Olher: <br /> I hereby certify that I have teed 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 w11 be compiled win whether specified herein or net The granting of a permit does not trewme to"auth"to violate or can"'al <br /> the provision of any other state or local law regulating constnucton or the performance of construction Thar I sm autorized by the owner of this property <br /> to�a work lot which application is made and I comply with the State Contractors Law 18 27 RCW and 298 200 WAC <br /> OwnarlAulho ed Agenl Blgnatun D e <br /> (Revised 212011) <br /> fj� <br />