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i . <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 /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> SITE ADDRESS: PROPERTY TAX U PERMIT# <br /> -7C-)/ / Ti 2Th c i 151 Lib g- 001" <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> OWNERI / /Y( /0 E iZ/1i {4.L6-,1 Phone/E-mail <br /> Address -t'� <br /> ({/� _cpa / ��A-t 1 Ci &/(`= City/State/Zip �)<,y.:(� 7 LL,- �� <br /> APPLICANT:_Owner _Owner's Agent _C� ontractor _Contractor's Agent _Tenant(must provide a letter of consent from the owner to do work in the space) <br /> CONTRACTOR CD��'I,f?‘..)ft C i,}J /,,,(14,(441/ &I Lic.# Mill - cfT COE Bus. 'c.# <br /> Address 7 Cry /2_/S7 jj' i S (4_, L` ` Al X -A hone/Email c C i e.-2c YT,w , ?C)i i <br /> TENANT BUSINESS NAME / CONTACT F R PERMIT <br /> ' /T F Ii Phone/E-mail `fZ 1 j 7-4/c <br /> tec_16--ecchdiC044 <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK I0O <br /> Existing Use of Building /1/44.1u 1-44-C 7iAiP G/f HEAT SOURCE: <br /> Proposed Use of Building 5-7-.4‘.4/ . Gas _ Electric Other_ <br /> Building type: Single Family Duplex Townhouse _Mult9rnily —mmercial <br /> Type of project: _New _Addition _Remodel Repair 4. --1-.1. Sign Sprinkler Demolition Change of Use <br /> DESCRIPTION OF WORK(additional space provided on the back): <br /> 5-7 •=1- e.— Al eta.) 72.00 g Sy s--7- F 41,n — i,J L ( G <br /> e.) <br /> Ar' 0 4 A S& OPP&ts <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 f Shower <br /> Gas fireplace Kitchen sink&disposal <br /> Gas range Dishwasher <br /> Clothes dryer 1 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 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 prope•• •perfo the work for which application is made and I comply with the State Contractors Law 18.27 RCW and 296.200A WAC. <br /> r \12._ <br /> 1 i 41 <br /> Owns Authorized Agentiggnature Date (Revised 6/2012) <br />