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05/11/2416 WED $: 9$ FAX Fast ATatOY HOdtOY —_449/445 <br /> *PERMIT APPLrCATI <br /> BUILDING/MECHANICAL/PLUMBING/SIGN/SPRINKLER/DEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 Cedar St., Everett, WA 98201 4,25-257-8810 FAX 425-257-8857 www.everettwa.org <br /> SIT f DRESS: i �In WA P11 PER T tlIT tPo t l ^ <br /> LEGAL for now construction: Short Plat/eubdivisfon Lot No. (attach copy of long Legal description) J� <br /> OWNER Prt� 14/ Vtl i 1} �1 Phone/C-mail `� Ll W—( q <br /> Addrees Io m) `/U CASINO X I O— <br /> Cfty/Stats/'Ip <br /> APPLICANT':_Owner w Owner's Agent Y,Contractor _Contrpctor's Agent Tenant(must provide a Ietteraf wnaent tram rile ownYr la do workin the apace) <br /> CONTRACTORfEl L�LdIaQ State Lia.# wW�JOHg Ity Bus.Lie. <br /> lel N ucM �( <br /> Address —ELL Vu ( lel .. Phone/Small <br /> TENANT SS NAME CONNT�A.CT FOR PERMIT <br /> 1 <br /> Phone/E-mail e� <br /> 13UILDING PERMIT APPLICATION CONTRACT PRICE OF WORK Lok- <br /> Existing Use of Bullding <br /> Proposed Use of Bullding Galectrl-�L Other <br /> Building type: Single Family _Duple)( 7ownh Multi-Family Commercial <br /> Type ofro ect: New Addition Remode arpi air T.1. Sin Sprinkler Demolltlon Chane of Use <br /> DESCRIPTION OF WORK(addlUonel space provided on filo beck): <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> �71 <br /> ct: _New�ddn ­Alteration Repair Typa of Project: _Flew_rgddn —_Alteration Repair <br /> Show Number of fbaures Show Number # of Hxfures <br /> A/C—air handling units Toilet <br /> Forced air s stems Bathtub <br /> Gas i In Lavatorywash basin <br /> Water heater Shower <br /> s fire lace Kitchen sink&disposal <br /> Ga an e <br /> Clothe dr Dishwasher <br /> Ran e h <br /> Clothes washer <br /> Water heater <br /> Exhau fan Sink servlce/bar/mo /etc. <br /> Mea um Backflow preventer inside bldg) <br /> U ' heater Urinal <br /> ftfr�i <br /> Drinkin Fountain <br /> ratlon Floor drain <br /> W oodstove Gresse�tra <br /> Ducting Roof drains <br /> Other Medical Gas <br /> SP IN LER / SUPPRESSION SYSTEM, Other. <br /> Number of Heads Other: <br /> I hereby codify that I have read and examined this application and know the Berne to bo true and correct.All provisions of laws and ordlnanoes governing tills type of WCrk will be comp <br /> with whether sAedfled her+eln or not.The granting ate pertnit dose not preaurno to give authority to violate or CROCeI the provialon of any other state or local law regulating canstruotlort <br /> That I am authorized by the owner of Ihls properly tp perrorm the work for whtCh application Is made and I comply with the State Contractors Law 18.27 RCVII and 296.200A WAC. <br /> \OJA A <br /> Owtter/ uthorized .gent 9lgnatur® ' <br /> Date (Revised 4/2015) <br />