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i <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 />A-ao_ly <br />SITE ADDRESS: <br />2TR4 CT s <br />21 2 rsp S- <br />PRO PE RTY TAXX <br />O 1104 CDODS D <br />P RMIT l D�I <br />AtAbb <br />LEGAL for new construction. Shod Plallsvbdiviston r nPb.sbC U e 0 a WT Lot No:� (atlach copy of long legal description) <br />OWNER V (S V N 6 C_T C u G R2 I <br />nhone.'6mail ), 5 ; - 31 o ` "I 10 _ <br />77- <br />Address 21 2-? 2 -.x,e s-r S k) CaylstatelZip E V I. V-jrtT W Q Q J;b <br />APPLICANT: Owner Owner's Agent Contractor Conitactors Agent _Tenant ("urininnionconsent tram da ewnnto aaweA wine ua <br />CONTRACTOR ALL C Li n F r q?/ m& ii R G <br />Stale L_Ic. N LLCL LN 4 L (, Cil Bus Llc. a o f 2 2 <br />Address f 7Sz• hIr4,7t.G, CT J�LfbnlOq� Igot L PhonrlEmail 7-S-'?H1n-30 li <br />TENANT BUSINESS NAME <br />CONTACT FOR PERMITaR so u 1J ui.y P H ki F. S <br />lPhone/E.mail 2 0 tc - S S 1�- <br />BUILDING PERMIT APPLICATION <br />CONTRACT PRICE OF WORK <br />Fvisimg (Ise of Building _ HEAT SOURCE <br />Proposed Use of Building Gas Electric Other_ <br />Building type _ Single Family _ Duplex _Townhouse _ Mulli•Famtly _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 />MECHANICAL PERMIT APPLICATION <br />PLUMBING PERMIT APPLICATION <br />Type of Project: 41 __Addn _Alteration _Repair <br />Show Number (a) of fixtures <br />Typo of Project ._Now _Addn _Alteration __Repair <br />Show Number (A) of fixtures <br />A/C - au handling units <br />Toilet <br />Forced airs stems <br />Bathtub <br />Gas piping <br />Lavatory (washbasin) <br />Water heater <br />Shower <br />Gas fireplace <br />Kitchen sink & disposal <br />Gas range <br />Dishwasher <br />Clothes dryer <br />Cothes washer <br />- --- -- }— Range hood <br />Water healer <br />Sink (ser itcelbarlmop/etc ) <br />_-_ <br />Exhaust fan <br />Heat pilmD <br />Backllow, preveriler <br />Unit heater <br />Urinal <br />Boiler <br />Drinking Fountain <br />Refrigeration <br />Floor dram _ <br />Woodslove <br />Grease trap <br />Uucung <br />Roof drains <br />ri�niu <br />Medical Gas <br />SPRINKLER I SUPPRESSION SYSTEM <br />Other <br />Number of Heads <br />Other <br />I heoeby cendy roar I have tend and erami and lhil applicalMn and LWw the some lobe roue and rtnrrecl All proVRIOaS of IAwf and ordinances isionning this type ai Web not be CATPlied <br />with whether specified herem w not The granting of a perm does nor prosurile to gin summary to violate or unearths pinsioan of any other slate ob local Ww regulating construction <br />That tam aulhwided by the owner of this Popeny to perform the wore lot which eppi"bmn Is mode and I comply with One Stale Coinoders Lew 18 72 RC W and 296 2DOA WAC <br />OwI�A+�o-r <br />MVIAulhorlred Agent Sliffelure Date (Revised 3R013) <br />