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from: <br />02/2'112012 11:41 0595 P.002/002 <br />GJ'� 1p�3 <br />PERMIT APPLICATION <br />BUILDING/MECHANICAL/PLUMBING/SIGN/SPRINKLER/DEMOLITION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 Cedar St., Everett, WA 98201 - 425-251-8810 - FAX 425-257-8857 - www everettwa org <br />APPLICATIONS ATIONS ARE ACCFPTFO FROM a AM TO 4 PM z `Z- — <br />SITE ADDRE S: <br />- p z c •. `� <br />PROPERTY TA a <br />o 3pC�C�o zoD <br />PER IT a <br />U <br />LEGAL for new construction Snort mevauuu�wsbn __ Lol No _ _ (anecn copy of Iona bill daaanptlon) <br />�rj: <br />OWNER to S <br />PMnorE+nul <br />A41ro6e7u�!) 1ZQC1 ImoI,^,`` ` C <br />CONTRACTORNQ <br />ClYlstale,:�p E�e�e-N W `18ZG8 <br />L61LIc # <br />r <br />AtlOrosa I L-�.�IO 132 'tie 1:.+ <br />�1 .. `�' 034 <br />t " w 7 -1 rnonn/Email � , 7 <br />TENAN D SINESS NAME <br />CONTACT OR MIT1031o•� <br />�ul�c C as . carol <br />PnonME.mnll (, Q � =t. <br />BUILDING PERMIT APPLICATION <br />CONTRACT PRICE OF WORK Z. Z Ln -- <br />Existing Use of Building "21 C e HEAT SOURCE: <br />Proposed Use of Building Go Electric Other <br />Building type: X Single Family _ Duff x _Townhouse _ MuRhFamlly —Commercial <br />Type of project: —Now _ Addition i Remodel X Repair _ T.I. _ Sign _Sprinkler _DemolRion_Change of Use <br />Description of Work (additional span provided on the bad) <br />Rem,sle.l rep\ 4l' e 5 90 vO cI� \r\ 0 ,A44 w j � A K\e 1s v n t-4-, <br />Have you started working without a permit? .___YES __NO <br />MECHANICAL PERMIT APPLICATION <br />PLUMBING PERMIT APPLICATION <br />type of Pmlect: _ Naw,_-Addn XAfterstion _Repair <br />Show Number (a of fixtures <br />type or Pro)ecC -_Now _Addn _Allorallon __ Repair <br />Show Number of axrurs3 <br />A/C - air handling units <br />Toilet <br />Forced elf s stems <br />Bethlub <br />use piping <br />I <br />Lavatory wash basin <br />Water heeler <br />I <br />Shower <br />Gas fireplace <br />Kitchen sink 6 disposal <br />Gas range <br />Dishwasher <br />Clothes dryer <br />Clothes washer <br />Ran a hood <br />Water heater <br />Exhaud tan <br />Sink (service/bar/mop/etc <br />Had pump <br />Backfow proventer <br />Unit healer <br />Urinal <br />Boller <br />Drinking Fountain <br />Floor drain <br />Rohl oration <br />MWoodetove <br />Grease trap <br />Ducting <br />Roof drains <br />Other <br />Medical Goa <br />SPRINKLER / SUPPRESSION SYSTEM <br />Other: <br />Number of Heads <br />Other: <br />1 hereby certify that I have rand and examined this application and knowthe same 10 be true and contact All Provisions of Isws and ordinances governing <br />this type of work wit be complied with mother spedhod herein or not The granting of a permit does not presume to give authority to vmlale or cancel <br />the provision or any other stale or local low regulating conslruckon or the performance or eansiroction. That I am authorized by the oveter or this property <br />to perform the work for which application is made and 1 comply with the Stale Contractors Law Is 27 RCW and 29e 200 WAC <br />/9.4fib1 f ale Z 2Z I2 <br />ns-U orisad Agent pmitura ate (Revised b201q <br />