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gvtwm6 ' Ft <br /> PERMIT APPLICATION uMa F-5 <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 /> 28O51QDDIQ3e.D <br /> SITE ADDRESS: ss PROPERTY TAX# PERMIT# <br /> � �(o• ► 9' bp..„, LgDr`/9rrJO/���DD (1,046 — O63 <br /> P��.Z{v►J of C. <br /> LEGAL for new construction: Short PlaUsu6dlvlsion Lot No. (attach copy of long legal description) <br /> OWNER NtORTALLM COVRT LLC- Phone/E-mail 1.e z het vv.AiA a padride knitter.cam <br /> Address 17 9 Z1 to-u.-Eve? t-T- t4Wy. S tnT - 11Z7 City/State/Zip for4 51,t_ 1 1 • [OW t 2 <br /> APPLICANT:_Owner ✓Owner's Agent _Contractor _Contractors Agent _Tenant(must provide a letter of consent from the owner to do work in the space) <br /> CONTRACTOR S 't 145 '410 e+ State Lic.# City Bus. Lic.# <br /> Address SaM►Q as above. Phone/Email SGM"Q QS at)ole. <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT <br /> Phone/E-mail S-A e.Q'r DCA O1/f' <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK 4 mat Zt SR 0 <br /> Existing Use of R""t.+'...- tVA _ HEAT SOURCE: <br /> Proposed Use in tiuilding_,4TVA tA)'s /d`t Gas Electric Other <br /> Building type: ✓Single Family —Duplex ✓•Townhouse ✓Multi-Family Commercial <br /> hype of project: ✓New —Addition _Remodel _Repair T.I._Sign Sprinkler Demolition Change of Use <br /> IESC RIPTION OF WORK(additional space provided on the back): <br /> M k i OME Vkr1T' ( <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type of Project: ✓New_Addn _Alteration_Repair Type of Project: ✓New_Addn __Alteration_Repair <br /> Show Number(#)of fixtures Show Number(#)of fixtures <br /> A/C—air handling units 3 Toilet <br /> / Forced air systems 2 Bathtub <br /> 2. Gas piping 3 Lavatory(wash basin) <br /> J Water heater Shower <br /> Gas fireplace / Kitchen sink&disposal <br /> Gas range _ / Dishwasher <br /> / Clothes dryer / i Clothes washer <br /> l Range hood er <br /> 7" Exhaust fan • Sink(service/bar/mop/etc.) <br /> / Heat pump / ( Backflow preventer <br /> Unit heater Urinal <br /> Boiler j Drinking Fountain . <br /> Refrigeration j Floor drain • <br /> Woodstove f Grease trap <br /> Ducting Roof drains <br /> Other Medical Gas <br /> SPRINKLER/ SUPPRESSION SYSTEM Other: <br /> 1 Number of Heads ( Other: <br /> ,.ereby 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 this type of work will be complied <br /> with whether specified herein or not.The granting of a permit does not presume to give authority to violate or cancel the provision of any other state or local law regulating construction <br /> That I am authorized by the owner of this property to perform the work for which application is made and I comply with the State Contractors Law 18.27 RCW and 29 . OA WAC. <br /> Revised 3/2013 <br /> Owner/Autho,gent Signature Date ( ) <br />