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PERMIT APPLICATION <br />BUILDING/MECHANICAL/PLUMBING/SIGN/SPRINKLER/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 />SITE ADDRESS: GG <br />ib d <br />pROPT RTY TAX$1 <br />P HtaIT a D 10 <br />LEGAL rot new construction ShortPlattsubdivislon Lot No.—_ (attach copy of long legal description) <br />OWNER -1 <br />PhoneiE m-17--goLoj <br />Address E / - <br />CitylStalelzip <br />APPLICANT:-jSOwrer OwneriAgenl Contractor Contractor's Agent_Tenanll^w+19eraeeh+erdcmumnomawwrvraeo.a.nmeta�.1 <br />'" <br />CONTRACTOR <br />Cat Bus. Lic d <br />State Lic, k Y <br />, <br />Address PhonelEmall <br />TENANT BUSINESS NAME <br />�CERMIT �,. nr�j p� W}Q <br />CONTyAT <br />Phone, +(J1 a_-6�,wV".d�y74.i J <br />BUILDING PERMIT <br />CONTRACT PRICE OF WORK_ <br />�APPLICATION <br />Existing Use of Budding _�-_yLW? HEAT SOURCE: <br />Proposed Use of Building ' Gas Electil Other <br />Budding type Single Family _Duplex _Townhouse _ Multi-Farndy _ Commercial <br />Type of project New Adddion Remodel Re air T I Si n S rinkler Demo:ilion Chan a of Use <br />DESCRIPTION OFWORK (addd,onalspeceprowdedonPre back) <br />2) .1?A i .ti J y ram- ev1 rr <br />' T LLP�+-.L C✓cf. r1�a�J rig, n <br />MECHANICAL PERMIT 'APPLICATION <br />PLUMBING PERMIT APPLICATION <br />Typo or Project _New _Addn _Altarallon_11epan <br />Show Number 0)of fixtures <br />Typo or ProJeLt. _New _Addn __ Altemnon . Ttepan <br />Show Number N)of fixtures <br />A/C - air handling units <br />Toilet <br />I Forccd a,r systems <br />Bathtub <br />Gas or In <br />Lavalo wash basin <br />Shower <br />Water heater <br />_ <br />Gas fire lace <br />Kitchen sink 8 disposal <br />Dishwasher ____ <br />Clolheswasher <br />Water heater _. <br />Sink servicelbarlmo /etc. _ <br />_- <br />Gas range <br />Clothes d er <br />Range hood <br />lantan <br />aExhausl _ <br />Heat pump <br />heater _ _ _ <br />Boiler <br />Backflow provender <br />_ <br />_ _Unit <br />I Urinal <br />Drinkin Fountain <br />Refrigeration <br />Floor drain <br />_ <br />Ducling <br />Other <br />Grease trap <br />Roof drains <br />_ <br />Medical Gas <br />SPRINKLER I SUPPRESSION SYSTEM <br />Other <br />Number of Heads <br />Other. <br />I hereby certify that I have read end eaamined Iho applicaton and Srcw nth Same I La two and correct At pmwslont of laws end "dog ¢es goveming this Into or work ml be cumphed <br />wish whether specified heroin or rot The pronlog of a perm) does not presume to glre put ri,dy to violate or cancel the Provision of any caher dote ar local low legutaenp conalnrdnn <br />.hat I am authorized by the owner of mill propene Io perform the wed' v which 0PP11C8 ion 4 made and 1 comply wary the Slate Convaclors law 16 ar RCW and 796 200A WAC <br />5 <br />Cc'm <br />