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• • <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 /> lo g--)41 <br /> SITE ADDRESS: PROPERTY TAX# PERMIT# <br /> ` 7(7/ I 1- ��]� Y-r, V r°: f ( 0 C05- <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> OWNERL L( (S ' 4,03- (t¶1 kl01� 2Phone/E-mail <br /> Address J City/State/Zip <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 � CU--n5--nocilAAte Lic.#C n� <br /> / ' C (.4City Bus. Lic. # <br /> Address �� { �rl- I I\ , f Phone/Email i(4, •' - <br /> TENANT BU3tNSS NAME" 'J' ( �(/ ONTAerFOR PERMIT`j <br /> Phone/E-mai4(0 <br /> i <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK <br /> Existing Use of Building S �� HEAT SOURCE: <br /> Proposed Use of Building S (nLZ 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 /> 5Cp Mob ,e \Annul DA Ick t \ O . <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 i Bathtub <br /> Gas piping Lavatory(wash basin) <br /> Water heater J Shower <br /> Gas fireplace Kitchen sink&disposal <br /> Gas range i Dishwasher <br /> Clothes dryer I 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 j Medical Gas <br /> SPRINKLER / SUPPRESSION SYSTEM ( j Other: ti)(�,4-f (( <br /> Number of Heads Other: J_p41 (f.u/ <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 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. CC <br /> /I/0.. <br /> /0- ,�Owne/u or zednt �Date� (Revised 3/2013) <br />