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Feb. 4. 2016 10: 48AM No. 1873 P. 3 <br /> • <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 /> SITE ADDRESS: { j PROPERTY TAX# <br /> LEGAL for new construction: Short Pletlsubdivis ion 1 of NO, (attach copy of long legal description) <br /> OWNER OAU f'. l� L�.v Phone/E-mail i7 y `i'. ,'r�'"" <br /> Address c . � a City/State/Zip LUA— <br /> APPLICANT: Owner .Owner'sAgent Contractor Contractor's Agent Tenant(muxtprnvidnaInttnrntrnnnonttromtheovncrtodowwkinthaapace) <br /> CONTRACTOR jY,¢._. ut-t State Lic. rtftZ[ ,=;r=� ;c City Bus.Lic.# <br /> Address -'; 64) U;.. �tT "Y i Phone/Lmall <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT <br /> Phone/E-mail 4i�- —�k"-(, AA UV <br /> (;r}— <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK 'walla' i-O et./ <br /> Existing Use of Building HEAT SOURCE: <br /> Proposed Use of Building "X Gee Electric: Other <br /> Building type: Single Family _Duplex Townhouse _Multi-Family Commercial <br /> Type of project: ,New _Addition Remodel Repair Ti._ Sign....._Sprinkler_Demolition Change of Use <br /> DESCRIPTION OF WORK(additional space provided on the Dash): <br /> E <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type of Project: New_Addn;r< Alteration_Ropalr Type of Project: New_Addn _Alteration_Ropalr <br /> Show Number(#)of fixtures Show Number(#)of fixtures <br /> A/C—air handling units Toilet <br /> k Forced air systems Bathtub <br /> Gas piping Lavatory(wash basin) <br /> Water heater Shower <br /> Gas fireplace Kitchen sink&disposal <br /> Gas range Dishwasher <br /> Clothes dryer Clothes washer <br /> Range hood Water heater <br /> Exhaust fan Sink(service/har/mop/etc.) <br /> Heat pump Backflow preventer <br /> Unit heater Urinal <br /> Boiler Drinking Fountain <br /> Refrigeration Floor drain <br /> Woodstove Grease trap <br /> Ducting Roof drains <br /> Other Medical Gas <br /> SPRINKLER / SUPPRESSION SYSTEM Other: <br /> Number of Heads Other: <br /> I hereby certify that I have read and examined thin application and know the same to be true end correct.All provisions of laws and ordrrrrric:n.gnvreinirg glls type of work vAfl be comp) <br /> with whet er specified heroin or not,The granting of a permit does not presume to give authority to violate or caecal the ruovininn of any outer state or local law regulating construction <br /> t hat I a lthriin:d by the owner of this property to penorm the work for which onplic:atknt iii made and I comply with the Stele Contractors Lew 15.27 RCW and 206.200A WAC <br /> r2/5 <br /> wner1 thorized Agent Slgnaturo /ate (Revised 8/2014) <br />