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� <br /> PER�'AIT APPLICATION <br /> BUlLDING/MECHANICP.�IPLUMBING/SIGNISPRINKLERIDEMOI.ITION <br /> CI7� OF EVERE7T PERMIT SERVICES <br /> 3200 Cedar Sl., Everett, WA°8201 -425-257-8810—FAX 4?5-257-8857—www.everettwa.org <br /> APPLICATIONS ARE ACCEP7ED FROM B AM TO 4 PM S— �/�Z <br /> SITE ADDRESS: � ' vROaExTY TAIf M PIERMIT N <br /> -\1031 SE EVF,RET? U.�R9g?�{ 005 4 c�lo� o -�'� <br /> LEGAL for new conslruction: Short PlaVsubdivision Se�,�iov�Zn'���n�Q _Lnt No._ (attach wpy of long legal descriplion) Ssa. aa� <br /> OWNER �U� c�1T.� IY� • � Pnone/E-mail <br /> Atldress �q.{ ES'�Gt�C. <br /> . Po BoX B�JOC'�t �itylState2iP Bel�av�.�a., u)a �t$al�j <br /> CONTRACTOR ConS L 8 I Lic.S N TCOC 2O <br /> Address y-�(� �Gy1�Q,. �c �C.ZOS �C u�a• a�`�^^"� PhonelEmail �� �Z,�j. LL'�J�t.�o"✓ <br /> TENANT BUSINESS NAME CONTACT FOR PERMR (7� � <br /> A{�/S�(.� �J�1. Tt�'� U'Lfn.�� Vl�iOh PhonelE•mail �i�uo.2V��YteY Nl ���a�c1+.Go� <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK ,00 <br /> M ��� .� �K� HEAT SOURCE: <br /> Exisling Use of Building � — <br /> Gas Electric Other <br /> Pmposed Use of Building �� �A�`��! — — <br /> Bwiding tyFe: _Single Family _Duplex_Townhouse _Mr�lti•Family /�Commercial <br /> Type of project: _New _Addition _Remodel _Repair�,T.I._Sign,_Sprinkler_Demolition�Change of Use <br /> DesCription of Work(additional space p/ovided on the back): ��� �� `��� ./�� ��K/�'�A l�.{�. <br /> NOr�1-��.vC-'U1Z.a,l, rtEr�A�-tr IM'P2v�/ Pt�� l <br /> i� a.r-�.�,c�s�n,�(� gn,rJr- S,PAGE �B�LJ�. W��{C INLLUDE�i ItilOrl.�i� G�I�S� <br /> Have you started working wilhout a permit4 __YES �NO N1 f I.�I�W 0�—.K� 1.(!a F/T7N6/d'�jN1�f�Es . <br /> MECHANICAL PERMIT APPLICATiON PLUMBING PERMIT APPLICATION <br /> Type ot Project: _New_Addn _Alteratlon_Repalr Typn oi ProJect: Sh weNumber(M)o/flxtutaBStion_Repair <br /> SM1ow Number(N1 oi�xt�res <br /> AIC—air handlin units Toilet <br /> Forced air s stems ___ Bathtub <br /> � Gas i in Lavato wash h3sin <br /> � Water heater Shower <br /> Gas fireplace _ _Kitchen sink 8 dis osal <br /> �as ran e <br /> Dishwasher <br /> Clothes d er Clothes washer <br /> Ran e hood Wacer heater <br /> � Exhaust tan Sink servicelbar/mo /etc. <br /> Heat um Backflow reventer <br /> Unit heater Utinal <br /> � Boiler Dnnkin Fountain <br /> Refri eralion Floordrain <br /> � Woodstove � Grease tra <br /> Ducting Raoi drains <br /> Other Medical Gas <br /> SPRINKLER i SUPPRESSION SYSTEM other: <br /> Number of Heads Olher: <br /> I hereby certify that I have read and exaniined this appliwtion and knowthe same to be tme and wrtect.All provisions of lav.s and ordinances goveming <br /> this type of v.ark will be wmplied vnth wfiether specifieC herein or not.The granting af a permil does not presume lo give authonty to viWate or wnce� <br /> the provision of any other state or local law regulating construction or the pedormance of ccnstrudion.That I am aulhorized by the owner of this property <br /> to pedorm the v.o for wh� p licalion is maae and I wmply vnth the State Contractors Law 18.27 RCW and 296200 WAC <br /> � �f 2 7�/Z <br /> OwnerlAuthorized ent Signature <br /> �ate (Revised 2R071) <br /> �L <br />