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ICUI (4>cJ& `L <br /> PERMIT APPLICATION VOIT B-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 /> '2.812 51 CA70103z171) <br /> SITE ADDRESS: PROPERTY TAX# PERMIT# <br /> I4z 0 _ rI S" Z�'v. i9�v/n3)4OP - Us - <br /> LEGAL for new construction: Short Plat/su6dtvis on 2iN�1 -f I,4i. Lot No. (attach copy of long legal description) <br /> OWNER P RTt41.L fc WI/k-1— 1—LG Phone/E-mail torrte)VIN CVA e pti Atrid9CLower.CAM <br /> Address 17 9 Z1 L-E1/5anl t4L4)Y. S t tT&j WV City/State/Zip g77"N 51.1, 1 141,4• av d('Z <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 5.244^4- aS cub ove State Lic.# City Bus. Lic.# <br /> Address Sam CSS 8.60112_ Phone/Email Sly ar a6oue. <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT <br /> Phone/E-mail SLUMP--A.r ac"b ove <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK $ I5 at S 9 D <br /> Existing Use of Ri,iI't '- WA HEAT SOURCE: <br /> , <br /> Proposed Use ur tsuflding_ 4 Ac 1441'14/bh Gas ✓. Electric Other <br /> Building type: ✓Single Family Duplex ✓Townhouse ✓Multi-Family Commercial <br /> ,-hype of project: ✓New Addition _Remodel Repair_T.I._Sign_Sprinkler Demolition Change of Use <br /> iESCRIPTION OF WORK(additional space provided on the back): <br /> NSIO SIJ i4o►E VIinT" g-2 <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 /> NC—air handling units '? Toilet <br /> 1 Forced air systems ._ Bathtub <br /> 2— Gas piping 3 I Lavatory(wash basin) • <br /> 1 Water heater Shower <br /> Gas fireplace I Kitchen sink&disposal <br /> Gas range 1 Dishwasher <br /> 1 Clothes dryer 1 i Clothes washer <br /> t Range hood .`(_l-----A'"r ` "`eater <br /> g- Exhaust fan • Sink(service/bar/mop/etc.) <br /> Heat pump 1 Backflow preventer <br /> Unit heater Urinal <br /> Boiler j Drinking Fountain <br /> Refrigeration Floor drain • <br /> Woodstove Grease trap <br /> Ducting Roof drains <br /> • <br /> Other 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 is made and I comply with the State Contractors Law 18.27 RCW and-298:2081A <br /> WAC. <br /> Owner/Authori gent Signature / Date - (Revised 3/2013) <br />