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OPERMIT APPLICATICO <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: <br /> (a/Z Li (� OO5/TY Tpz Do/e9OO� 6110 i t)--1)61 <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> OWNER -V��77 /5 -r7/11 96/7/ /7/ Phone/E-mail 77725-75-e57: <br /> qz z z— <br /> Address D�DD/ /s--377 City/State/Zip(7/9/ 972e77— <br /> APPLICANT:){ <br /> ffz 2/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 /91/J0G/q/ State Lic.# 6-1,1t1/(:,4-C_ t°i jU I Z. City Bus. Lic.# <br /> Address Phone/Email <br /> TENANT BUSINESS NAMEAMCONTACT FOR PERMITgq„_,o y �E-ZT1 -- <br /> ,e <br /> ge4��'" /` '� Phone/E-mail y2 r 293 56 7�jr7- <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK /66°o, oa <br /> Existing Use of Building .J IC_ HEAT SOURCE: <br /> Proposed Use of Building ,-5-/4"--/e Gas X Electric Other <br /> Building type: Single Family _Duplex Townhouse Multi-Family Commercial <br /> Type of project: New Addition A/Remodel Repair T.I. Sign Sprinkler Demolition Change of Use <br /> DESCRIPTION OF WORK(additional space provided on the back): <br /> \CfaU. ittIMU} <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type of Project: NewAddn)(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(inside bldg) <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 compl <br /> with whether sp ' ed 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 l am auth6ri d by the wner 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 /> Owner/Authorized Agent Signature Date (Revised 4/2015) <br />