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� � <br /> PERMIT �4PPLICATI�ON <br /> BUILDING/MECHANICAL/PLUMBING/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 /> SITEADDRESS: �OZ J��� � PRi��TYT ���D� OO OQ PE MITI# !l O� <br /> l(%V <br /> LEGAL for new construction: Short PlaUsubdivision �-1"l�� � 1 �I��Lot No��(attach copy of long legal description) <br /> OWNER �'Tf'� �� Phone/E-mail 2Q6 � 1'(� -- J��.Sf <br /> Address �j60,D — ZNd � , � City/State/Zip ���Si�tLl.�� �1/}' gj"2,�"0 <br /> APPLICANT:�Owner _Owner's Agent _Contractor _Contractor's Agent _Tenant�m�5�Pro�ide a ieuer ot�or,5e�i rrom ine owr,er io do work m�ne sPace� <br /> CONTRACTOR � UIl�1 Qhlfifi State Lic.# City Bus. Lic.# <br /> Address b b�° � ���J�-. �� �/U'�S{/j 1.�� � l o� Phone/Email �'7�� ¢��6 — �� <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT �� �n ,�_ t <br /> t-(`� rvm� <br /> �����)�C�N � � �1 H�> Phone/E-mail C 2 0�f `T �t �b"+ J J 2,� <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK�o� 4 DO � <br /> Existing Use of Building t�i-�/�K� ��- � HEAT SOURCE: <br /> Proposed Use of Building 1``+'a i •"'"'ri'N"r f��l- 1/ Gas I� Electric_ Other <br /> Building type: _Single Family _Duplex_Townhouse _Multi-Family ✓Commercial <br /> Type of pro e! ct: _ New _ Addition Remodel � Repair_✓ .I� Si�n ,��S�rinkler Demolition _Change of Use <br /> DESCRIPTION OF WORK(additional space provided on the back): <br /> �_oP�.s �r� ' sN�("�� ` I�� , t�F-w N�tME ` �i47'� � w.ro�il. N� <br /> oNr�.�.s�-ti/�. G��+T� 1�-� �� 7'0; �-rr � �� (�r►�z. ��� . <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type of Project: _New_Addn _Alteration_Repair Type of Project: _New_Addn _Alteration_Repair <br /> Show Number(#)of fixtures Show Number(#)of fixtures <br /> A/C-air handlin units Toilet <br /> Forced air s stems Bathtub <br /> Gas i in Z Lavato wash basin <br /> Water heater � Shower <br /> Gas fire lace Kitchen sink&dis osal <br /> Gas ran e � Dishwasher <br /> Clothes d er Clothes washer <br /> Ran e hood Water heater <br /> Exhaust fan 'Z,,, Sink service/bar/mo /etc. <br /> Heat um Backflow reventer <br /> Unit heater Urinal <br /> Boiler Drinkin Fountain <br /> Refri eration Floor drain <br /> Woodstove Grease tra <br /> Ductin Roof drains <br /> Other Medical Gas <br /> SPRINKLER I SUPPRESSION SYSTEM � Other: <br /> Number of Heads I Other: <br /> I hereby certify that I have read and examined this application and know the same to be true and correct.All provisions of laws and ordinances governing this lype of work will be compl <br /> with whether specified herein or not.The granting of a permit does not presume to give authority to violate or cancel the provision of any other state or local law regulating construction <br /> That I ain authorized by the owner of this property to perform the work for which application is made and I comply with ihe State Contractors Law 1827 RCW and 296.200A WAC. <br /> ,--�a����f <br /> �� a� �! � l�f � <br /> O erl ut rized Agent Signature Date (Revised 9/2014�.'� <br /> / <br />