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!evil-b i Kv, `I4-a <br /> PERMIT APPLICATION UNIT <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 /> tc�-t-� `?it 2.Sosigoo io3e.at) <br /> SITE ADDRESS: Oa'O 1f1PROPERTYTA)Ut Peltlib9 001 <br /> PnvO vR �G1" <br /> LEGAL for new construction: Short Plat/��subdlvislon Lot No. (attach copy of long legaldescription) <br /> OWNER 14=41..1M GOVR� LL Phone/E-mail L.LzI'elWL4 Lta.�cnrjd9CL,M&scam <br /> Address 7 Z! ISp (, MQ;>p,tr (�41,(�y SL tT6 Ifs City/State/Zip g,v'E1-t— t 1,04. WV(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 5. 't a'S vl.bOUe, State Lic.# City Bus. Lie.# <br /> Address SCfM"Q CIS a6o1Jia Phone/Email SGML tar above. <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT <br /> Tim ?hotllaS <br /> Phone/E-mail s"ol wot.a r ac,b ovG 22-11 Eve e ttlig:,rvo fit Z01f <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK t" 2-26' t o 4' _ <br /> Existing Use of R,d'r't"_ WA HEAT SOURCE: <br /> , <br /> Proposed Use or building_ A.TrAC43 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 /> .ESCRIPTION OF WORK(additional space provided on the back): . <br /> N' t7N i•toia6 VIn r , -1 14-03 'C?tT <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 /> NC—air handling units 4 Toilet <br /> I Forced air systems 2. Bathtub <br /> 2 Gas piping S Lavatory(wash basin) <br /> 1 Water heater I Shower <br /> Gas fireplace I Kitchen sink&disposal <br /> Gas range ( Dishwasher <br /> t Clothes dryer t j Clothes washer <br /> I Range hood �4-- �eL <br /> Exhaust fan • _ ,r--A---- <br /> Sink(service/bar/mop/etc.) <br /> 7 Heat pump I Backflow preventer <br /> Unit heater Urinal <br /> Boiler Drinking Fountain <br /> Refrigeration Floor drain <br /> Woodstove Grease trap <br /> Ducting Roof drains <br /> • <br /> Other Medical Gas <br /> SPRINKLER/ SUPPRESSION SYSTEM I 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 WAC. <br /> 2-1 /...21-20/y <br /> OL- .Owner/' •rized Agent Signature Date d 3/2013) <br />