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PERMlT APP�.ICATION <br /> BUILDINGIMECHANICALIPLUMBINGISIGNISPRIf�KLEFcIDEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 Cedar St., Everelt, WA 98201 -425-257-8810—FN! 425-257-8857—www.everetlwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM �'aD`'"�2 <br /> SITEAD�RESS: ��ERETT WA ZOB PROPERTYTAXk PE MITp <br /> /0/0/ /9TN AI�E. S.E. ST�. A— / �ZPOSZOOO,ZOS7�0 � <br /> LEGAL for new constmclion: Short PlaVsubdivision_ Lol No.__ (attach copy ol lonq legal description) <br /> OWNER < ��E7'T�' SG'NDf/OLN PhonelE-mail �{Z5-j9B ,�00 �MS[N��io�/�'J`�a� � <br /> Address /7/D /oorN Sr�� STE. /02- ci�y/s�a�e�ziu El/E E� W� 9B��g <br /> CONTRACTOR L/.VN—DOU641 6 CO STRU�T�CF/ L 8 I Lic.# L�N�/DrGL D00 PG <br /> naa«s�'•�� B�,�' BO/9 CO v/n1G ToN wA BD`�2- P��9 �ro�Em'f 9-`�'�3� irk�/inn-�o a .fo.fy <br /> TENANT BUSINESS NAME CONTACT FOR PERM� �� zC6- 3�}9- �Z�'� <br /> EDWARD ✓ON�S � /ESBS K/QK F/GEN � <br /> Phone/E-mail %' �//1/) —�CU �a s• � <br /> BUILDINGPERMITAPPLICATIUN CON7ttACTPRICEOFwORK <br /> Existing Use of Building ��vT r r 'f �j�( c� HEAT SOURCE: <br /> Proposed Use of Building �r.r�C(r' f �n�� Gas X Eiectric_ Other_ <br /> Building Iype: Single Family _Duplex_Townhouse Multi-Family X Commercial <br /> Type of projecC _New _Addition _Remodel _Repair�T.I._Sign_Sprinkler_Demolilion_Ch2nge o(Use <br /> DeScripliono(Work(addilionalspace0�ovidetloniheback): AI�(� �/�/]��LTE�L VS/<]�..(_`d' � �����. L Iy� <br /> ���� f� �� U(Q� D�et�� P��T � G4T���� � �OA �/.1r�7-t��-��'�l <br /> H a y-ou started wo- rking withDur a permil? _YES �NO <br /> MECHANICAI PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> TypeofProJect: _New�,Addn _Alteration_Repair TypeofProJect: _New_Addn _Alteralion_Repair <br /> Show Number(#)o/fixfures Show Number(It)o/lixtures <br /> I A/C—airhandlin9units . I I Toilel <br /> Forced air s slems I Balhlub <br /> Gas pipin ( ��.I Lavato (wash basin) <br /> Walerheater � Shower <br /> � Gas fireplace I Kitchen sink 8 dis osal <br /> ran e i ishwasher <br /> ��I Cloth d er ', C es washer <br /> ' Ran e ho I Water aler <br /> • Exhaust fan I Sink(serv lbar/mo�letc. <br /> � Heat pump I Bacicflow prev ler <br /> '� Unil healer � l�rinal <br /> i Boiler Drinking Founlain <br /> '� Floordrain � <br /> j Refri eration Grease lra <br /> � Woodstove ' <br /> I Ducln i Roof drains <br /> � Other_ � Mediwl Gas <br /> SPRINKLER I SUPPRESSION SYSTEM I� Other. <br /> ��� Number o(Heads � Other: <br /> I here0y certily lhat I have iead and eKamined Ihi,application and know the same lo be Ime and correcL All pmvisions of laws and ordinances governing <br /> thi,type of work will be complied wilh whelher�peFilietl herein or not.The granling of a permil does not presume�o give authority to violate or cancel <br /> �he provision of any o�her slale or local law fgu ting consimction or the pedormance of conslmction.Thal I am authorized by lhe owner of Ihis pm0etly <br /> to pedor���fo whic plicalio��nd I compfy wrth ihe State Contraclors Law 7827 RCW and 296200 WAC I <br /> • �I . l � • 12 <br /> OwnedAulhorized AgenlSignaturc <br /> Date fRevised2/201Q � <br /> Z <br />