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. <br /> 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.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> SITE ADDRESS: <br /> ,natr y f �,S i 6 �� PROPERTY TAX# <br /> V1 5 p �o P„ J2(NI�i_ /QO2- <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) V <br /> OWNER P7(7-e(j/ls3 Phone/E-mail <br /> Address 0O? (A Las ow City/State/Zip eve remj V yr l „ 0 tf <br /> CONTRACTOR 'Cif r(l14 V C>01.--k L&I Lic.# (rt rl C/ i(5 63- <br /> A <br /> 37 <br /> Address 7/7/I ?j `{� kt � VV/14 (16632,-Phone/Email <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT YS Vt,l=f�,i,L., ro <br /> (30-e t 0-9 1-1 , (. 0 S 'ie'2 <br /> Phone/E-mail k (,(S-(�j e ko rrvc_akt—s'(j <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK 41'01 00 U <br /> Existing Use of Building HEAT SOURCE: <br /> Proposed Use of Building Gas_ Electric_ Other <br /> Building type: _Single Family _Duplex_Townhouse _Multi-Family _Commercial <br /> Type of project: _New _Addition _Remodel _Repair_T.I._Sign_Sprinkler_Demolition_Change of Use <br /> Description of Work(additional space provided on the back): <br /> brij <br /> y� con vt,ec a ��Vitt bf� tet pPr bCc bl/,Ildti^-3 tb L4J fr alio .Y <br /> nn atacaI; Po.ct f e r-0 frt, <br /> Have you started working without a permit? YES ,(( NO <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type of Project: _New_Addn '✓Iteration_Repair Type of Project: _New_Addn _Alteration_Repair <br /> Show Number(#)of fixtures Show Number(#)of fixtures <br /> NC—air handling units Toilet <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/ SUPPRESSION SYSTEM Other: WGtsfe -t vvet c <br /> Number of Heads 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 <br /> this type of work will be complied with whether 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 the 0 . for which application is made and I comply with the State Contractors Law 18.27 RCW and 296.200 WAC <br /> 12pec�cs-� <br /> Owner/AuthoAgent Signature Date (Revised 2/2011) <br />