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PERMIT APPLICATION <br /> BUILDING/MECHANICAL-/PLUMBING/SIGN/SPRINKLER/DEMOLITION <br /> CITY OF F_VERETT PERMIT SERVICES <br /> 3200 Cedar St. Everett, WA 98201 -425-257-8810— FAX 425-257-8857—www.everettwa.org <br /> _ APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> SITE AUDRESS; PROPER CY TAY a PEP MIT a <br /> 410 8%^ 5T ScJ 15-J, <br /> n <br /> LEGAL for now construction• Short PlaUsu'division _Lol No._ (attach copy of long legal eeteriptlon' <br /> OWNER IVRIPA/ C0A/57WVC tl0A/ Phone/E-mail <br /> Address /0 &U 5151V S' .Tc AIcily/Slate/Zip F v&,s ti (n)N 0 3 <br /> CONTRACTOR u 57- 43 1 Q C L 8 I Lie.ft krD 2S q g( C W1 <br /> Address // (r/c's� Hwy 7.0.W^ 6UN7 PhonelEmeil„753'4i�N 'O 0 r r�;Y rar 4 r✓ ('.•r. <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT <br /> �crtflr+ :s Vic Sic S /u'fr t1.1 �'� �Ay (.•.� <br /> PhonalE•mail <br /> h1�5 y53 lam aft A(� ydC//rsS, rr�_ <br /> 3 '� ,`J <br /> BUILDING PERMIT APPLICATION ICONTRACT PRICE OF WORK G7IG <br /> Existing Use of Building HEAT SOURCE: <br /> Proposed Use of Building Gas Electric Other <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 back): <br /> ADD 5rc.Pnc,e d'.lercs <br /> Have you started working without a permit? ____YES —YNO <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Typoof Prn)oct: _New__Addn _Allerallon_Ropalr Typo of Project: _New_Addn _Alteration_Repair <br /> Show Number(A)of fixtures Show Number(0)of Rrfures <br /> _ A/C-airhandlin units Toilet <br /> Forced air systems Bathtub <br /> _ Gas piping Lavatory wash basin <br /> Water heater Shower <br /> Gas fireplace Kitchen sink&disposal <br /> Gas range Dishwasher <br /> _ <br /> Clothes dryer Clothes washer <br /> _ Rene hood Water heater <br /> _ Exhaust fan Sink(service/bar/mo etc. <br /> Heat um Backgow, reventer <br /> Unit heater Urinal <br /> Boiler Drinking Fountain <br /> Refrigeration _ Floor drain <br /> I _ Woodstove _ Grease trap <br /> Ducting Roof drains <br /> Other Medical Gas <br /> SPRINKLER / SUPPRESSION SYSTEM Other: <br /> I Number of Heads Other: <br /> I hereby certify that I have read and examined this application and know the some 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 or cancel <br /> the provision of any other state or local low regulating construction or the performance of construction.That I am authorized by the ownor of this property <br /> to pafform/the work for which application Is made and I comply with the Slate Contractors Lew 10.27 RCW and 29e 200 WAC <br /> Ownor/Author dAgent Signature Dale (Revised Z201 1) I <br />