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PERMIT APPLICATION <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.everetfinra.org <br /> SITE ADDRESS: �1� V�.�-(� � S,. 9 PROPeR�nr rAx# R i �� <br /> � w � <br /> LEGAL for new construction: Short Piat/subdivision Lot No. (attach copy of Iong legal description) <br /> OWNER �1Q'n� �t.��'� PhonelE-maii �`� � —� S f UU � ��_Cd <br /> Address ��3 CC��� Q � u� City/State2ip �� <br /> APPUCANT:_„Owner _Owner's qgent �Contractor _Contractor's P�qent _TenaM�musc ProWde a ienera conseMrrom me ownerco do woric�n me sPace> <br /> CONTRACTOR ('l�, l�,C_ State Lic.# ity Bus.Lic.# �i� <br /> Address 1.5� L� U[LQ��"�` � Cj UI�1.., '(l�J(i(;� Rhone/Em v� �"'J'�-[� <br /> TENANT B INE NA CONTACT FOR PERMIT <br /> PhonelE-mail � <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK <br /> Existing Use of Building HEAT SOURCE: <br /> Proposed Use of Building Gas Electnic Other <br /> Building type: _Single Family _Duplex_Townhouse _Multi-Family _Commercial <br /> T of ro'ect: New Addition Remodel Re air T.I. Si n 5 rinkler Demolition Chan e of Use <br /> DESCRIPTION OF WORK(additionatspace provided on the back): <br /> �V�����.0 f� a�� ��.�. �UC�-Q-� � �b : <br /> � <br /> . � . . � <br /> ��-e,�.�- c�� <br /> MECNANICAL PERMIT AP LICAT LUMBING PERMIT APPLICATION <br /> Type of Project: _New Addn Alteration_Repair Type ot Project: _New Addn _Alteration_Repair <br /> Show Number # of fixtures Show Number # of fiactures <br /> A/C—air handlin units Toilet <br /> � Forced air s stems Bathtub <br /> Gas i in � 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 /> Fachaust fan - Sink servicelbar/mo letc. <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/SUPPRESSION SYSTEM Other: <br /> Number of He s Other: <br /> I her y ce that I h e read eua ned th' ap �fon nc�know the same to be tnre and correct.AA provisions of laws and ordinances goveming this type of work will be compl <br /> with et r s ecifie erein o n t. } <br /> p granti of rtn' do s not presume to give aufhority to violate or cancel the provision of any other state or local law regulating consUuction <br /> Tha I thorized the o of th prope to o work for which pplica6on is made and I cOmply with the State Contractors Law 18.27 RCW and 29B.200A WAC. <br /> � ���cl�� <br /> O Authorized A nt Si nat Date (Revised 9l2014) <br />