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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.everettwa.org <br />ARE ACCEPTFn FROM A AM TO 6 PM r- I t ore -0/-/-1 <br />nrru.n u.. . <br />- - <br />PROPERTY TAX # <br />PERMIT # <br />SITE ADDRESS: <br />LEGAL for new construction: Short Plat/subdivisl Lot No. _ (attach copy of long legal description) <br />(qL5-) - q-72-o 'I <br />OWNER --�-AL Eor—,=T` iA3 i <br />Phone/E-mail <br />Address y <br />Cily/State/Zip C=Ur {C LAJ.�yA <br />U Ia <br />CONTRACTOR 1li�C 1T FZ ICA <br />L 81 Lic. # <br />Address I K H W 1 1- v <br />Phone/Email 'Lp <br />TENANT BUSINESS NAME <br />CON FOR P MIT <br />(TWT <br />SAr •£ <br />PhonOE-mail <br />BUILDING PERMIT APPLICATION <br />CONTRACT PRICE OF WORK _ A)-T <br />HEAT SOURCE: <br />Existing Use of Building <br />i Gas Electric -Other_ <br />�� - - <br />Proposed Use of Building — <br />Building type: Single Family _ Duplex _Townhouse _ Multi -Family Commercial <br />_ <br />Type of project: —New _Addition Remodel _ Repair_T.I. _Sign _Sprinkler_Demolition_Changge of Use <br />Description of Work (additional space provided on the back): <br />(!/ ICj20' jtC1f_0 (y1� ( �V"lFi n�f. US( <br />Have you started working without a pefmit7 ✓ YES _NO <br />MECHANICAL PERMIT APPLICATION <br />PLUMBING PERMIT APPLICATION <br />Type of Protect: _Now_Addn —Alteration —Repair <br />Type of Project: _Now_Addn _.Alteration _Repair <br />Show Number(#) of fixtures <br />Show Number (#) of fixtures <br />A/C - air handling units <br />Toilet <br />Forced air systems <br />Bathtub <br />Lavatory (wash basin) <br />Gas piping <br />Water heater <br />Gas fireplace <br />nk 8 disposal <br />Gas range <br />er <br />kW:aterterExhaust <br />Clothes drys <br />asher <br />Range hood <br />fan <br />ice/bar/mop/etc.) <br />Heat pump <br />Backffow preventer <br />Unit heater <br />Urinal <br />Boiler <br />Drinking Fountain <br />Refri eration <br />Floor drain <br />Woadstove <br />Grease trap <br />Ducting <br />Roof drains <br />Other <br />Medical Gas <br />SPRINKLER I SUPPRESSION SYSTEM <br />\ <br />Other p <br />Number of Heads <br />I e <br />C Other: L-1I%I-- l i <br />_ <br />r � cd nwi t�YiCxTInA <br />I hereby certify that I have read and examined this application and know the same to be two and c r`e t. All provislo 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 an other stale r local low regulating construction or the performance of construction. That I am authorized by the owner of this property <br />to perform the or 1 r hich aiolie n is made and I mply with the Stale Contractors Law 18.27 RCW and 296.200 WAC <br />(Revised 2/20f7) <br />Owner/Autho zed Ag Signaturo Date _ r1\ <br />