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PERMIT APPLICATION Mr - _2" <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 /> 15- t pr SIE 28os/goo/193Z.DID <br /> SITE ADDRESS: PROPERTY TAX# PE T <br /> tS®. , � zgo. /?PO/n.?Y•D„ c. Oct -017 <br /> tviliro op c• • <br /> LEGAL for new construction: Short Plat/suochvision Lot No. (attach copy of long legal description) <br /> 1 <br /> OWNER 404141-#1M GO(/ " LLC. Phone/E-mail Le s rte.)vii1/4 vt v. L pt At ria a iwities.Go,M <br /> Address I?IZl ItONaL'Et/ U r ally 517tTg IIP City/State/Zip gp151A_ t WA•• Red(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 SW'A't RS 0.bOVe State Lic.# City Bus. Lic.# <br /> Address SQA Cis R.b0 Phone/Email Stzm Qr a6ove <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT <br /> Phone/E-mail SAS ar ac,bovp_ <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK $ (�z, 5 k 0 <br /> Existing Use of RI,"-"-- /VA HEAT SOURCE: <br /> , <br /> Proposed Use or building_ AM4.c-t-4 -.1›, -11,1,44•144:21 - Gas f Electric Other <br /> Building type: ✓Single Family Duplex ✓Townhouse V'Multi-Family _Commercial <br /> --?ype of project: ✓New _Addition Remodel _Repair T.I. Sign Sprinkler Demolition Change of Use <br /> .ESCRIPTION OF WORK(additional space provided on the back): <br /> 1451.0 ICWW .1toM6 v tyr - 2 <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 /> ,/ Water heater Shower <br /> Gas fireplace / Kitchen sink&disposal <br /> Gas range / Dishwasher <br /> Clothes dryer / i Clothes washer <br /> Range hood <br /> al 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: <br /> Number of Heads I 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 WA <br /> Owner/Autho ' ed gent Signature Date (Revised 3/2013) <br />