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,, <br /> � � <br /> PERMIT APPLICATION / d� �� "� ' <br /> BUILDINGIMECHANICALIPLUMBING/SIGNISPRINKLER/DEMOLITlrJN <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 Cedar St., Everett,WA 98201 425-257-8810 FAX 425-257-8857 www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> SITE ADDRESS: PROPERN TA%N PERMIT# <br /> IOIIT �� CG4"� t..au �$o�l2Kdb2Uc,lc� —�L� <br /> LEGAL for new conslruction: S�ort Plat/subtlivision Lot No._ (atlach copy ot long legal description) <br /> OWNER �`n`1 l��"�e T �u2� �� � phone/E�mail <br /> Atldress '1� C��iK Sov� IXY 2"� F��r Ciry/State2ip �Q�i F•C � fT � �U�(� <br /> APPLICANT:_Ovmer _Owner'sAgent �CConlrac�or ContracmfsAgent _Tenantl�-sip�maeakne.oicmumnommawTe��oao+Aa��meswui <br /> CONTRACTOR Mt {� S�' �'� ��1'�S���5�'� L&I Lic.# � '�S�d3 8 COE Bus.Lic.# <br /> Address26�� ['WZ � ` SuSI '� �''�l U�N� w����273 PhonelEmail�424'i32S �j����e�ll(�{j'S� 4•c• <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT i � Y�C l,` <br /> �- �� W�-�2�('1325 .�. ���' wM/-tJ'Si 4.Co� <br /> PhonelE�mai <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK 7,5���� <br /> Existing Use of Building HEAT SOURCE: <br /> PioposedUseofBuilding ( V"�Vek��U�G S'�v�'� Gas_ Eiectric_ Other_ <br /> Buildingtype: _SinglcFamily _Duplex_Townhouse _Multi-Family �Commercial <br /> T pe of pro'ect: New _Addition _Remodel _Repair_T.I. Si n_Sprinkler_Demolition_Change of Use <br /> DESCP.IPTION OF WORK(additional space pmvided on the back): <br /> (��Tw� �� W.1M SC��S r� <br /> ` � i� �p Ia� cu {�•� u+oHv•..�.tiT S�y`1 <br /> �Vls�tt�� �}G lY.o./��w—�.-a_� St'.--� 1\ 'e � <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> TypeofProJecl: _New_Addn _A��eratlon_Repalr TypoofPro�ecl: _New_Addn _Allerotlon_Repair <br /> Show Number(q)of/lxtures Show Number(M)af llrfuros <br /> A/C—air handling units Toilet <br /> Forced air syslems Bathlub <br /> Gas piping Lavatory pvash basiN <br /> Water healer Shower <br /> Gas freplace Kitchen sink&disposal <br /> Gas ran e I Dishwasher <br /> Clothes dryer Clothes washer <br /> Range hood � Waler heater <br /> Exhausl fan � Sink(servicelbar/mopletc.) <br /> Heat pump Backflow preventer <br /> Unit heater Urinal <br /> Boiler Drinkin Fountain <br /> Refrigeration Floor drain <br /> Woodstove Grease irap <br /> Ducting Roof drains <br /> � Oth�r Medical Gas <br /> SPRINKLER I SUPPRESSION SYSTEM Other: <br /> Number o(Heads Other: <br /> 1 hereby cenJy ttial l liave reatl and c�amined Ihis applcalron antl know tlm same lo�e We anE cortect NI piovisions oi la.vs antl ordiwnces goveming Inis type olwork vnA be compliee <br /> vnth v.fielher specifieE herein ur noL T�e granting ol a permi�does nol presmne lo grve aultionty lo moiale or cancel I�e prov�sron ol any otlier slale or loral I,iw reguialing conslmclion <br /> ll�.nl l am aul�oiiie0�y Rre o�mer ol lhir propeM�o pedomt Ihe work lor wtiK�applealron is made anJ I compry rnth Ihe Slale ConUac�ors W'.v 1U P RCIV antl 29G 200A�7AC. <br /> '(�-c-�, `�-y t o-2`(-� � <br /> Date (Revisetl6/2072) � <br /> Owner/Authorized Ag Slgnaturo � <br /> � <br />