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0 <br />PERMIT APPLICATION <br />BUILDING/MECHANICAUPLUMBING/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 />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />SITE ADDRESS. sW <br />PRROOPERTY TAX4 O O <br />pERMITa 8 <br />LEGAL for new constrocuon Sriorl Rausubd-wslon LcA i lanacb cocy of or� r-;. �• . <br />OWNER Mill-4-4 OS Z r'« <br />phonerE-man <br />Address <br />Cary/5181e1Lo 4 8 <br />CONTRACTOR Les 1• 1eAA-f' <br />8 I Llc a q I00 sq <br />Address sn0 { MP Y. . � onti 9 $ % PnonelEmac <br />TENANT BUSINESS NAME <br />CONTACT FOR PERMIT 4wIt"� cown <br />a (0-a 7 7 y -7 3 e4, 1 <br />Phone/F-r- r aw h A) 5 kre. � '• <br />BUILDING PERMIT APPLICATION <br />1CONTRACT PRICE OF WORK_ 30 <br />Existing Use ofBuOdre__'5LsgN. FuIa+� __ __ HEAT SOURCE <br />Proposed Use of Building rJqt rv-T IC.. rm+-A., I V _ Gas Electric Other <br />B. lmng type KSmgle Family _ Duplex _Townhouse _ Mulb-Family _Commercial <br />Type of project - $New _ Addition _ Remodel _ Repair `T_ T' I Sign __.Sprinkler Demolition--C�hannge of Use <br />Descnpt`on of Work facid�t I space pmwtled on the back) E-y-.ffi s.` 1 oWs"e 'Y`• ` —I-0 -5 14; IY- 4 �II" 0 Imp <br />W • a� G or rea P�d'r`3 Va . P—" IQe..e— al •�+,y�y �CA.4i' C- <br />ho61B �k w •i.H wru, e�pra.�srcfA. of +r F, pay.• <br />Have you started working without a permd7 ___YES _ NO <br />MECHANICAL PERMIT APPLICATION <br />LUMBING PERMIT APPLICATION <br />Type of Project XNew _Addn _Alteration _Repair <br />SAow Number a) of fixtures <br />Type of Project. New_Addn __Alteration Repair <br />Sh Number (a) of futures <br />AIC - an handling units <br />Toilet _ <br />Forced an systems <br />Bathtub <br />Gas piping <br />Xavatory(wash basloll <br />Water healer <br />Sillispet <br />Gas fireplace <br />Kitchliq sink Ydisposal <br />Gas range <br />DlshwaS <br />Clothes dryer <br />Cloths a fir <br />Range hood <br />Watlfr heater <br />Ekhaust la,. <br />Sink fserince/baknopletc <br />Heal Pump <br />vente <br />Unit healer <br />/ Uhnat <br />Bailer <br />/ Dnnkm Fountain <br />Refrigeralron <br />Floor dram <br />Woodstove <br />Grease trap <br />_ <br />Ducting <br />Roof drams <br />Other _ <br />Medical Gas <br />SPRINKLER / SUPPRESSION SYSTEM <br />Other <br />Number of Heads <br />Other <br />I hereby ce4dy that 1 have read and examined Ihn apphceron and know the same to be rue and correct All provisions of laws and nrdmances governing <br />th s type of work will be complied vein whether specified herein or not The gtanbng of a perms does not presume to give aufhcnty tic violate or cancel <br />the provision of any other state or local law regulating construclmn or the performance of consrucrnn Thal I am aulhorued by the owner of this property <br />to peAe,m the work for which aopicaben is made and I comply wth the Slate Contractors Law 16 27 RGW and 296 200 WAG <br />L1 LAC L 8- <br />OwnerlAuthonied Agent Signature Clale (Revised 21201 U / <br />