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- <br /> N <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 425-257-88 www,everettwa.org <br /> SITE ADDRESS: PROPERTY TAX# PERMd <br /> 102'04 Jt AVE W 1 11/111611—)1 I <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach ,..py of long legal description) <br /> OWNER A &w a. Te.tett.3 Phone/E-mail 42.5 131 . 741 <br /> Address W /2.1 3 9 t et itV City/State/Zip 1..,,,j i IA y v1,+4 Gt 0 WA C S X37 <br /> APPLICANT: Owner Owner's Agent 4,2ontractor Contractor's Agent Tenant(must prov :'a letter ot nenset from the owner to do wOdc tn the space) <br /> it <br /> CONTRACTOR <br /> gLt=-,eY`til SAWS State Lig.# et:lk 4014= 44,8 City Bus.Lid.# 00"36 <br /> Address 74449 Aye NE / +c't/1 A 'goo Phone/Email �•Ski/ -•• .C3/ r <br /> TENANT BUSINESS E CONTACT FOR PERMIT <br /> 14441N4-141 I I r ; ,l ri Phone/E-mail 4 i 4 it.. • ` si &' 0 MAI 1.GO <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF W <br /> Existing Use of Building 1 HEAT SOURCE: <br /> Proposed Use of Building G Electric_ Other <br /> Building type: _Single Family Duplex Townhouse Multi-Family Commercial i <br /> it <br /> ype of project: —New Addition —Remodel —RepairTi. __.Sign _Sprinkler 40emolitionChange of Use <br /> DESCRIPTION OF WORK(additional space provided on the back): <br /> MECHANICAL PERMIT APPLICATION ( PLUMBING PRMIT APPLICATION <br /> Type;of Project _,_New, Addn _Alteration Type of Project _New_,•,,. n „__Alteration_Repair <br /> Show Number 1#)of fixtures Show Number ()of fixtures <br /> A/C-air handling units Toilet <br /> Forced air systems Satt tb <br /> ,, <br /> .1 t Gas pipl . l..av ry(wash basin) <br /> Water heater Sho r <br /> Gas fireplace W Kitchen sink&disposal <br /> a Gas range 1 1 Dishwasher <br /> Clothes dryer Cloths washer <br /> Range hood We heater <br /> Exhaust fan Sink• rvir arlmop/etc:) <br /> Heat pump B..« .+- preventer <br /> Unit heater thin <br /> Boiler I DM:CI • Fountain <br /> Refrigeration i Floor drain <br /> Woo stove Grease trap <br /> Ducting Rootlrains <br /> I Other.A A Medal Gas <br /> SPRINKLER/SUPPRESSION SYSTEM Othe <br /> Number of Heads 1 Oth , <br /> I hereby certify that I have read and examined this application and know the same to be true and correct At provisions of laws andi rdinan es governing this type of work will be cam{ <br /> with whether • ••herein or not.T *granting of a permit does not presume to give authority to violate or cancel the provision 1,any other state or local law regulating construction <br /> That I am a .. he lawn .is pro. •- cm the work for which application is made and I comply with the State CarLaw 1827 RCW and 29$200A WAC. <br /> It <br /> Owner/Authorized Agent Signets' re flats s (Revised 9/2014) <br />