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rL11lv11 I hr F %..0 r-1, I IV1. <br /> BUILDING/MEC•NICAL/PLUMBING/SIGN/4F1NKLER/DEMOLITION <br /> CITY OF EVERETT PERMIT SER7TCES <br /> 3200 Cedar St., Everett, WA 98201 425-257-8810 FAX 425-257-8857 www.everettwa.org <br /> SITE ADDRESS: PROPERTY TAX# P RI�11T <br /> Li ,� 00/%92 , ,o/e90 00 0 III <br /> LEGAL for new construction: Short Plat/subdivision Lot No: (attach copy of long legal description) <br /> OWNER !/� � t/f.7iv� //�yD/e/ly Phone/E-mail Y2 57-2X-e57, <br /> AddressD d� /J y7 City/State/Zip 6---U‘7/67/77/(.//4 9Z /" <br /> APPL1CANT:X Owner _Owners Agent _Contractor _Contractor's Agent Tenant(must provide a letter of consent from the owner to do work in the space) <br /> CONTRACTOR /9/i)G,47, State Lic.# J r>t, kc1 10 1 Z City Bus. Lic.# <br /> Address Phone/Email <br /> TENANT <br /> /fBUSINESS NAME CONTACT FOR PERMIT,,q�,'y �6Z 7,i/ ° <br /> g67/. Phone/E-mail 293 7/ /3 - <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK /6'0 O. O <br /> Existing Use of Building 5-/ce HEAT SOURCE: <br /> Proposed Use of Building �/C--/e • Gas ir Electric_ Other__ <br /> Building type: —Single Family _Duplex_Townhouse Multi-Family _Commercial <br /> Type of project: New Addition X Remodel Repair T.I. Sign Sprinkler Demolition Change of Use <br /> DESCRIPTION OF WORK(additional space provided on the back): <br /> t Ilk,rt <br /> MECHANICAL PERMIT APPLICATION • PLUMBING PERMIT APPLICATION <br /> Type of Project: New_Addn X 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.An provisions of laws and ordinances governing this type of work will be <br /> with whether sped 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 constr <br /> That I am autho d by the o ner of this property to perform the work for which application is made and I comply with the State Contractors Law 18.27 RCW and 298.200A WAC <br /> bobs._ <br /> Owner/Authorized Agent Signature Date (Revised 4/20. <br />