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• • <br /> PERMIT APRLICATIC�N <br /> BUI�DINGIMECHANICA�/PLUMBING/SIG(�/SPRINKLER/DEMO►LITI(�N <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 Cedar St., Everett, WA 98201 425-257-8810 FAX 425-257-8857 www.everettwa.org <br /> SI E ADDRESS: PRQPERTY TAX# PERMIT tJ /� <br /> "�J�- V Y1�t�" 1�7c��c'i'8�� C� rl'_ (/ � <br /> LEGAI tar r3ew c�nstrucUnri: Short PfaVsubdrvision _ Loi No.�.....,_ (atiach capy of iong legai c�escription} <br /> OWNER �,�,lt. � { �-�(,.1''� PhonelE-ma�i �p�� ' (� ' <br /> Address CitylStatelZip <br /> APPUCANT: Owner Owner's Agem Gontractar ,___._Contractor's Agent Ten2nt(mus:provide a iener o+c.orsent tr�rr�u7e aw^+»r ro da w-or<�=z the s��cef <br /> CQNTRACTOR ,�,n�yti„Q.�r1 State Lic.� � � K-`�i City Bus. L�c �(�at � pi d <br /> Address �) .� � ,,,(_ g � �,g PhcneJEmaii `��j •p(� � ' ��b <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT a„i�y�i� .Wti,�v�.a.�''1 <br /> PhonelE-mait (�Yn�i-t�� . � <br /> BW L�ING PERMIT APPLICATION CONTRACT PRICE QF WORK `� '�o�� <br /> Existing Use of Buiiding �� � HEAT SOURCE: <br /> F'roposed Use of Bwiding �_ Gas �! Eleciric__,__ Other.,_„ <br /> Building type: _...__ ingie Farruly �Dupfex�.TUwnhouse �Multi-Fa ily _Commerciai <br /> T c oE ro ect: New Additicrn Remodei Re air T.I Si n S rinkler Remo(ition Chan e of Use <br /> DESGRI TION OF WORK(�ddulona�sQaca pro��ded on tn�b� k�. � {''� <br /> � r(l �.a-�� i '� � 00 � �k�,> (�V C�'�-C S 5 �A- T- <br /> MECHANICAL PERMMT APPLICATION PLUMBING PERMIT APPLICATIt)N <br /> Type of Project: _New_Addn uAlteration�Repair Type af Pro]ect: _New_Addn �Alte�ation_Repair <br /> Show Namber # of fixtures Shaw Number t4)of fixtures <br /> ' AlC—air handlin units Toilet <br /> Forced air s stems Bathtub <br /> Gas i in � Lavator wash basi� <br /> ( Water heater Shower <br /> i Gas fire lace Kitchen sink&dis osai <br /> ! Gas ran e i Dishwasher <br /> �� ClQthes d er ( Giothes washer <br /> ! Ran e hood ` tNafer heater <br /> ���� ExhausC fan Sink(s�rvlce,'barimople�c.' <br /> ' Neat purr� Backflow reventer <br /> Unit heater Urinal <br /> Boiler Drinkin �auntain <br /> Refri era6or� �loor drain <br /> �Vaodstove Grease traA <br /> Ductin Roof drains <br /> Other Medica!Gas <br /> SPRINKLER / SUPPRESSION SYSTEM I Otner: <br /> i <br /> hJumber of Heads Other� <br /> t harobN ceridy lhat 1 hava rQad-and exam�necl this ta{�iptical�an 8nd knaw!he 5ame to t�e true<intl Corc�t;t.All�rravisi4ns�t laws and ordin2nces govhrn�n4 thss ry(�a+e�'.w�rk w�ll hci eonap <br /> -n w�tir�ther specified he�em ar nerl_The:g!anpny oF�p�rnzrt tloas npt pr�surne 4n givo authc�rity t�violato or cancei the provis�r�n df any other state or Iacai law rc?gu(ating r.+arvstruotlon <br /> Tha i Am authona��f t�y fhe own r ol this prap�.riy to perform the wofk fnr w ich appl�c'tion i^,m:�de�ntl f compiy ve;th lhe 5tatp E�antractors Law 58.2�Rf;b'V;an0 7.;1ti.2Q0A'vVAG, <br /> ' � � � �� ! � <br /> nerlAuthorized AgQnt Sigr�ature Defe (kevis�ct�tI2014) <br />