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BL-t )G 'K' <br /> PERMIT APPLICATION VST r <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 /> 28057gco/93e.vV <br /> SITE ADDRESS: PROPERTY TAX# PERMIT# <br /> I 05 i7 - t 1—IYd'' b%ss Zkai'l9 /P..Y-on C[�Da -O33 <br /> ��� ►'°FNe`5-� w <br /> LEGAL for new construction: Short Plat/subdivision 2 1Lot No. (attach copy of long legal description) <br /> OWNER iltellitAM GOAT' LLG Phone/E-mail L Ineltr►.P4 a totskrjd9ehvw4PS to,M <br /> Address t7WZi -E/ btT' ctivV . SLtTEf IVO City/State/Zip gm5u_ t t&JA QBt2(Z <br /> APPLICANT:_Owner ✓Owner's Agent _Contractor _Contractor's Agent Tenant(must provide a letter of consent from the owner to do work in the space) <br /> CONTRACTOR 541^^k, RS °Mb 0 ve State Lic.# City Bus. Lic.# <br /> Address $I:UA- CIS RUM- Phone/Email .Ccovt Ar R v Otte. <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT <br /> Phone/E-mail Sam-a r al vv_ <br /> BUILDING PERMIT APPLICATION -- __ <br /> CONTRACT PRICE OF WORK t Z-% SI t? <br /> Existing Use of Ridt.r..-- ‘`I/A _ HEAT SOURCE: <br /> , <br /> Proposed Use yr building_ A.WA 1A.)t. . 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 /> JESCRIPTIOpp��NO��FgqWORK(additional space provided on the back): <br /> Iv�W tvww RVIcev jyr . <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type of Project: ✓New_Addn Alteration_Repair Type of Project: ✓NewuAddn _Alteration_Repair <br /> Show Number(#)of fixtures Show Number(#)of fixtures <br /> NC—air handling units 3 Toilet <br /> / Forced air systems Z. Bathtub <br /> 2. ( Gas piping ,3 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 _ �.. WExhaust fan • Sink(service/bar/mop/etc.) <br /> Heat pump ( Backflow preventer <br /> Unit heater / Urinal <br /> Boiler j Drinking Fountain . <br /> Refrigeration Floor drain • <br /> Woodstove Grease trap <br /> Ducting Roof drains <br /> Other Medical Gas <br /> SPRINKLER/ SUPPRESSION SYSTEM I Other: <br /> INumber 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 296.200A WAC. <br /> Owner/Au on d Agent Signature Date •evised 3/2013) <br />