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0 <br />0 <br />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 />SITF DRESS. r^ I <br />pR6PERTY'TAXit <br />PE tAlli,t5� 3 D �� <br />LEGAL h:r nrw wnspuy:-n Jh0!}I•i.hbn:idiyp:pn Lul do iw-a..:�htl copy of long legal desuglu') <br />OWNER I fell <br />Phone/E-mad •y <br />APPLICANT'. a—�r..,•. _C.vnrr'; Age•,I Cun'rxle• Ccn`.'n"cs:•.•rt iena^.1-.:;.t........,.,r.,,....:r,-...,:.-,.�,.,,,.. .. •-..r.,-a <br />CONTRACTOR <br />Sta'c Uc a C ty Rus Lic a <br />A dd•ess PrvinoLrnml <br />TENANT BUSINESS NAME <br />CONTACT FOR PERMIT <br />prere E.ma <br />BUILDING PERMIT APPLICATION <br />CONTRACT PRICE OF WORK 4 <br />Ex sling Use cf But'dn.(.j _ _— __—._ _--. HEAT SOURCE <br />Proposed Use of Budding ___,_. Gas_ Electric_ Other <br />Building type ZSingle Family _ Duplex _Townhouse _ tilulti•Fam ly __ (,on•mercial <br />T pe of project _ New Addition Remodel Repair T 1 Sign Sprinkler Demolition_ Change of Use <br />DESCRIPTION OF WORK (admhonal space providedon the back) <br />d{? eop{ A6L.EJC <br />MECHANICAL PERMIT APPLICATION <br />PLUMBING PERMIT APPLICATION <br />type of Projecl Ne.v _Addn .-_ _Alterabun _Regan <br />Show Number Ill) of If, lures <br />Typo of Project _New __ _Addn _Allerallon _Rupair <br />Show Number(#) of totlures <br />AC - a r handling units <br />Toilet <br />Forced air systems <br />Bathtub <br />_ <br />Gas piping <br />Lavatory (wash basin <br />Water heater <br />Shower <br />Gas fireplace <br />Kitchen sink 8 disposal <br />Gas fan a <br />Dishwasher <br />Clothes dryer <br />Clothes washer <br />Range hood <br />Water healer <br />Exhaust fan <br />Sink service/batlmop/efo ) <br />Heal pump <br />Backgow preventer <br />Unit heater <br />Urinal <br />Boller <br />Drinking Fountain <br />Refricieration <br />Floor dram <br />_ <br />Woodstove <br />Grease trap <br />Ducting <br />Roof drams <br />Other <br />Medical Gas <br />SPRINKLER I SUPPRESSION SYSTEM <br />! <br />Other _ <br />Number of Heads <br />Other <br />1 hereby te^ It ihnl 1 have toad and esammed this application and an" the same lobe true end wrreel AM provisions of lows and wrimances aevermna this type of work will be complied <br />well whi lha specdted hnnn or not The granting or a pennA does not presume to at" oulhwity to w0lale or cancel the Provision of any other state or lout Jew resuming cOM1111 n <br />Thal I am Authorded by the owner of this property to perform the work far wn¢h applsabon a rhado and I comply wrlh the Slate contractors Lew 18 07 RC W and 295 200A WAL <br />Ala <br />(Rewsed.W013) <br />