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URAN N& t F ' <br /> PERMIT APPLICATION UUrr F2.. <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 /> 2SO5Igoo ro3e.c o <br /> SITE ADDRESS: PROPERTY TAX# PERMIT# <br /> 8 OS l e 6�, �� ZB'o. 19VD/n.i y-Ovt c fyoc!- oWvv <br /> P��.11170of c • <br /> LEGAL for new construction: Short Plat/suodtviston Lot No. (attach copy of long legal description) <br /> OWNER greeTtitAr.e. COVR-r LL Phone/E-mail Le S MI V^Cl.W itL P 1 rj d9e lnrues•GoitM <br /> Address 17 q ZI toturytt-EVVarr Ref. S t9tT S (127 City/State/Zip gfjJ14 ELL t 1,(>i4. 4E301 2 <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 S 'G Q'S. 0.boVe State Lic.# City Bus. Lic.# <br /> Address St.7M"Q ter ab00a. Phone/Email gawk as above. <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT <br /> Phone/E-mail .C. 'Q'r tat ow_ <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK 1'I5-2-t SR 12 <br /> Existing Use of R"tt.+'.._ NVA - HEAT SOURCE: <br /> , <br /> Proposed Use cif building_ 4T1 c l Gas ✓ Electric_ Other <br /> Building type: ✓Single Family —Duplex ✓Townhouse ✓Multi-Family Commercial <br /> hype of project: VNew _Addition _Remodel _Repair_T.I. Sign Sprinkler Demolition Change of Use <br /> )ESCRIPTION OF WORK(additional space provided on the back): <br /> M61.0 "taA,N i.lol vki r •f-2MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type of Project: ✓New_Addn Alteration_Repair Type of Project: ✓NewAddn Alteration Repair <br /> Show Number(#)of fixtures Show Number(#)of fixtures <br /> A/C—air handling units Toilet <br /> Forced air systems Z Bathtub <br /> !Z Gas piping 3 Lavatory(wash basin) <br /> / Water heater Shower <br /> Gas fireplace / I Kitchen sink&disposal <br /> Gas range / ( Dishwasher <br /> I Clothes dryer / Clothes washer <br /> /--- Range hood ater <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 Floor drain • <br /> Woodstove Grease trap <br /> Ducting Roof drains <br /> Other I Medical Gas • <br /> SPRINKLER/ SUPPRESSION SYSTEM Other: <br /> 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?s made and I comply with the State Contractors Law 18.27 RCW and 296. ;AC. <br /> Owner/Auth'Agent Signature Datesed 3/2013) <br />