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3u1(4)(1\1 1c1 <br /> v VIZ--G- I <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 /> 2Svsignorvse,PA) <br /> SITE ADDRESS: PROPERTY TAX# PERMIT# <br /> 1 i # '' FIS _ Zgvf9ov1o3�vn CI -0414. <br /> LEGAL for new construction: Short Plat/su��6dlvislonof C. Lot No. (attach copy of long legal description) <br /> OWNER I4bRTt49..dM G491) - LLC. Phone/E-mail Le%het W.P4 eiCt riidge Invwies,rom <br /> Address 17'IZI 13t)U1% tL-EVv4,ur cwt. 5t9►TG 1127 City/State/Zip grri4 51A_ t 1. • 100(2- <br /> APPLICANT: <br /> APPLICANT:_Owner ✓Owner's Agent _Contractor _Contractor's Agent Tenant(must provide a tetter of consent from the owner to do work in the space) <br /> CONTRACTOR SSG RS 0.b0Ve State Lic.# City Bus. Lic.# <br /> Address saw txS abloVIa. Phone/Email StZM 1 tar Qh vv . <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT <br /> Phone/E-mail S..D.AMt-a s /kb vee_ <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK 4 (8 c, 'la&2. • <br /> Existing Use of Pi,,"-- , <br /> VA HEAT SOURCE: <br /> Proposed Use or tsunding_ 4TrA0' Gas w'''' 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 /> JESCRIPTION OF WORK(additional space provided on the back): � 1-06,— !V�' <br /> N'Sto icWN 1101 ukt1r G- { t <br /> MECHANICAL 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 3 Toilet <br /> I Forced air systems rl. Bathtub <br /> 2. Gas piping .j Lavatory(wash basin) • <br /> I Water heater Shower <br /> Gas fireplace I Kitchen sink&disposal <br /> Gas range I I Dishwasher <br /> I Clothes dryer I i Clothes washer <br /> Range hood •._4. lalater-14 , <br /> 4 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/SUPPRESSION SYSTEM I Other: <br /> INumber of Heads 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 296.20+A +._.. <br /> <& 7- Z3• Zvr y �l <br /> Owner/A or ed Agent Signature Date - <br /> -w ed 3/2013) <br />