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WERMIT 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: PROPERTY TAX# <br /> A- o� RD, I I P� I 40 <br /> LEGAL for new construction: Short Plat/subdivision Lot No. <br /> r}n A (attach copy of long legal description) <br /> OWNER (JfS CO5 J N ETT u <br /> Phone/E-mail lc— / c 3E.°0 <br /> Address I--A PD\SOP.J City/State/Zip &V ST v/A- 98;L$33 <br /> APPLICANT: Owner Owner's Agent _X Contractor _Contractor's Agent _Tenant(must provide a letter of consent from the owner to do work in the space) <br /> CONTRACTOR AC0 'State Lic. # <br /> i5CJCL:jr`k o/A/X.-City Bus. Lic. #je37?t42 <br /> Add71.4 57 t.A0 <br /> 9 <br /> one/Email <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT <br /> U MA c j SCI 7-7// Phone/E-mail(2.06—T,Sc ^ EDQ D' -c°Q-°61Pc 1/11 <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK 4 / g pop <br /> Existing Use of Building <br /> HEAT SOURCE: <br /> Proposed Use of Building <br /> 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 /> Mop\V-AIL E NZLis'J <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 Toilet <br /> 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/bar/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 this application and know the same to be true and correct.All provisions of laws and ordinances governing this type of work will be compi <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 uthorized 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 WAC. <br /> 1;-'.5 720 <br /> Owner/Authorized Agent Signature Dat_ (Revised 9/2014) <br /> 1/� <br />