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,A't,f).0A&• 'I 1 <br /> PERMIT APPLICATION <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 /> 2805/Lj00/93e.D'D <br /> SITE ADDRESS: PROPERTY 1051► P1 SE PRO4gor/90D/P3Y-Di, P�r��'#®vl ,_ <br /> 2 <br /> 1417Vto-1-1M0 vF 1 aN �`5-� u!• <br /> LEGAL for new construction: Short Plat/su6dlvislon I Lot No. (attach copy of long legal description) <br /> OWNER 4t+Rlt't M co/ 1-1-•C. Phone/E-mail Le Ptelvvs.t qi la FaeiA.crittykamer.Gam <br /> Address 17'ZI gonial EvVeztr t`4U)Y. StfITG ICP City/State/Zip gv)14 I JA • gel)I2 <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 $SG R'S CI-boV'e State Lic.# City Bus. Lic.# <br /> Address Samt as above. Phone/Email Scram Gtr Q b Dve. N <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT <br /> Phone/E-mail saAN't a Ot.3OVC',. <br /> _____ \ <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK 4 1 b9r 8(32 <br /> Existing Use of R,uta"..-- t4/A HEAT SOURCE: <br /> , <br /> Proposed Use or uuilding_ A,TrA'• -TrI,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 /> DESCRIPTION OF WORK(additional space provided on the back): . <br /> 1451.0 ICUM 1440ME vor ft- i go.l c& -tf <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 Z Bathtub <br /> Z 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 /> • , Exhaust fan • Sink(service/bar/mop/etc.) <br /> Heat pump / I 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 I SUPPRESSION SYSTEM Other: <br /> ...----.., I Number of Heads I Other: <br /> .,,iereby 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 .C. <br /> Owner/Auth ed gent Signature Date -,sed 3/2013) <br />