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PERMIT APP wl. ill N <br /> BUILDING/MECHANICAL/PLUMBIN IGN/S'RINK-LER/DEMOLITION <br /> CITY OF EVERETT PE- - -VICES <br /> 3200 Cedar$t, 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: -- --. ir'4PERM <br /> A' I IPRoPERTY TAXI! I IT* <br /> "D6)*"52-- f)Ve4jA°41 S I Sol:-001 <br /> LEGAL for new construction: Short Plat/subdivision Lot No._ (aftach copy of long legal description) <br /> OWNER Phone/E-mail <br /> Address City/State/Zip <br /> CONTRACTOR S I atit". Teel^ 67.444"t /- L&I Lic.# l'4 SU 'Th-l-1 e61.3)C-Y <br /> ( <br /> Address 5ee7 ?a- "r.e, 111.1.41 ('WU FIge 1,./.4 FOR PERMIT gi ,,,,,4w erii 5 teti \ <br /> I i rm <br /> V etet I.2...a/t-e----- Phone/E-mail des-". 4 43/ 17 74`e/192471P-AC' IL 6:11*1 <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK 0,066.61:, <br /> Existing Use of Building fee-Atli( HEAT SOURCE: <br /> ProposedUseUse of Building 4./Ar./ Gas Electric Other <br /> Building type: Single Family Duplex Townhouse Multi-Family Commercial <br /> Type of project: _New —Addition Remodel Repair T.I.__CS0,n Sprinkler Demolition Change of Use, <br /> Description of Work(additional space provided on/he beck): <br /> to/e0/."- 10 5,4.1a13 One- F74,51, ipuziei -e-ei <br /> Ckailmi &./e -4 A/6' <br /> Ix/Si/0 . 10A 4 <br /> Have you started working without a permit? YES NO iri• ..X.r 5/-1.41 podedv, <br /> MECHANICAL.PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> . , <br /> Type of Project: _New_Addn_Alteration...Repair Type of Project: _New...Adrin ......Atteradon Repair <br /> Show Number oa of fixtures Show Number(*of fixtures. <br /> A/C-air air handling units ' Toilet <br /> _ , <br /> Forced air systems Bathtub ., <br /> Gas piping Lavatory(wash basin) <br /> Water heater Shower <br /> Gas fireplace Kitchen sink&disposal <br /> Gas range Dishwasher <br /> Clothes dryer- Clothes washer <br /> Range hood Water heater <br /> Exhaust fan Sink(service/bar/mop/etc.) <br /> Heat pump Backflow preventer <br /> Unit heater Urinal <br /> Boiler Drinking Fountain <br /> Refrigeration Floor drain <br /> Woodstove Grease trap <br /> Ducting Roof drains <br /> Other Medical Gas <br /> SPRINKLER i SUPPRESSION SYSTEMOther: <br /> Number of Heads Other: <br /> _ <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 <br /> this type of work Mt be complied with vihether specified herein or not.The granting of a permit does not presume to give authority to violate or cancel <br /> the provision of any other state or local law regulating construction or the performance of construction.That I am authorized by the owner of this property <br /> to perform; <br /> wnr or Write ap ' on' ado and i comply with th,lState Contractors Law 18.27 RCW and 296.200 WAG <br /> OwnerfAutherized Agent Signature (Revised 2/2011) <br /> 1:-- <br /> , <br />