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PERMIT APPLICATION <br />BUILDING/MECHANICAUPLUMBING/SIGN/: PRINKLER/DEMOLITION <br />CITY OF EVERETT PERMIT SER`/ICES <br />3200 Cedar St., Everett, WA 98201 425-257-8810 FAX 425 257-8857 www.everettwa org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM '0 4 PM 'I o- —I Z <br />SITE ADDRESS: •�f / / / �f� f �� <br />/ <br />PROPERTY TAX 0PE <br />MIT e <br />LEGAL for new construction Shod PladalhubdbdlWsbn_-__ _-lot No (al'ach copy of long legal descnplion) <br />OWNER L %Al%A- �� L Lam/ S./ S <br />Phone1E-mall <br />Address 7/ S%•S.&- <br />p r� <br />Citylstatelzip L''✓(�l{r \ /�Z Ob <br />APPLICANT: —Owner Agent Contractor _ Contractor's Agent Tenant dov hMSPsu1 <br />_ownefe <br />CONTRACTOR I( (L.6h i n-`"' L 81 Licp ncoAf, 0"4 1-1 COE Bus Lic it <br />Addmss % ' � � S /[ � 1' % PnonelEmed <br />RT �(>nlbn� 7 a � ui S oi26- <br />TENANT BUSINESS NAME <br />CONTACT FOR PERMIT <br />1'I:ooe:F oral 2nC, 'j o0- I ;- <br />BUILDING PERMIT APPLICATION <br />CONTRACT PRICE OF WORK ;!-S0tO <br />Existing Use of Building • e.0 ✓- t'�S ' `I ! yvr s HEAT SOURCE: <br />Proposed Use of Building Gae Electric Other <br />Building type: _ Single Family '� Duplex _Townhouse _ Multi-Famiy —Commercial <br />Type of project: New Addition Remodel " Re air T.I. Sin Sloflnkler Demolition —Change of Use <br />DESCRIPTION OF WORK (additional space provided on the back): <br />MECHANICAL PERMIT APPLICATION <br />PLUMBING PERMIT APPLICATION <br />Type of Project: _New_Addn _-Alteration_Repalr <br />S wNumberp0jittifflinfures <br />Type of Project: _New_Addn _Alteration _Repair <br />Show Number (q of ❑stures <br />A/C - air handling units <br />Toilet <br />Forced air systems <br />Bathtub <br />Gas piping <br />Lavatory wash basin <br />Water heater <br />Shower <br />Gas fireplace <br />Kitchen sink 8 disposal <br />Gas ran a <br />Dishwasher <br />Clothes dryer <br />Clothes washer <br />Range hood <br />Water heater <br />Exhaust fan <br />Sink servicefbar/mo /etc <br />Heat pump <br />Backflow preventer <br />Unit healer <br />Urinal <br />Boller <br />Drinking Fountain <br />_ <br />Refdgeraliori <br />Floor drain _ <br />_ <br />Woodstove <br />Grease trap <br />_ <br />Ducting <br />Roof drains <br />Other __ <br />Medical Gas <br />SPRINKLER <br />/ SUPPRESSION SYSTEM <br />Other: <br />Number of Heads <br />Other: <br />I hmeby reflex that I have feed and evamared INS applmolrn end know the same to be hup lint correct An provbions of am and entrance, govemng the type of wmk w, be complied <br />w,h Mremer speahM hereinanot The 910,111,19 ofa pemld does nor pfenime to gne nuthordy to Winne or cancel the prod,"pf anyplhe„late or local law regdaMgr amtr.,n <br />Thal f sm wthorlaed be the owner of rope property to perform the won for whelf eppseaWn is made and I empty wth the Slate Conbactote Lew is 77 RCW and 29e 2DDA WAC <br />(Revised 6 <br />Ovfner/Authonxed Agent Signature Oste ': G :! <br />