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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 /> SITE ADDRESS: PROPERTY TAX# PTn# <br /> tlQS7 �v� � elOS0s"JaOC�Zl l3 O/ I U14'tfr (06 <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> OWNER Jeff (ff Oa ra,4\O/TOP.J//�4 )a/A O/1P 17, Phone/E-mail j FFg 6t Y.Ar/ArK Noir, d. <br /> . Address x23013 l7LZftULr .PD Ae f iIft7C V 3Q3 City/State/Zip rid lell fEc .(/-1- f ..2 <br /> APPLICANT:_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 f-f oil E C51.2 N r==2 State Lic.# City Bus.Lic.# <br /> Address Phone/Email <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT <br /> V c.i- AlAAl Du 5 "-L •m--r cr2%%rvt=art �«z? <br /> Plaene/E-mail Cft;-,q 71(16 G.o.„.4 2T A4A i2 ,,GO,✓I <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK SOD000 <br /> Existing Use of Building )VO e 11Lq HEAT SOURCE: <br /> Proposed Use of Building____LegiSj_clac_si Gas_ Electric Other <br /> Building type: Single Family _Duplex Townhouse _Multi-Family _Commercial <br /> Type of project: L New _Addition _Remodel _Repair_T.I._Sign Sprinkler Demolition Change of Use <br /> DESCRIPTION OF WORK(additional space provided on the back): c.:,c5 r.( S7@ LCT A- 16-1,1 (4 a 1 C.j `old 0 S7" KBS <br /> rte//7-41 0 YL q/-1-T a,9"a t7 fZj j s KA-I" ,a.•eo a Pt P j- bI c l+, aN� c c,vGe Ela <br /> PL--GIC 4,117,iL 51.1 )G <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type of Project: jL New_Adds Alteration_Repair Type of Project: a_New Addn _Alteration_Repair <br /> Show Number(#)of fixtures Show Number(#)of fixtures <br /> NC-air handling units 4 Toilet <br /> 1 Forced air systems } Bathtub <br /> Gas piping 6 Lavatory(wash basin) <br /> Water heater 2. Shower <br /> 1 Gas fireplace i Kitchen sink&disposal <br /> Gas range 1 Dishwasher <br /> Clothes dryer Clothes washer <br /> ► Range hood <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 /> Z PG../9 cE Grease trap <br /> Ducting Roof drains <br /> Other Medical Gas <br /> SPRINKLER/SUPPRESSION SYSTEM Other: <br /> Number of Heads Other: <br /> I hereby certify -: ave read a 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 comp <br /> with whe--r s.:cited 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 ..t .r' ed by the owner. this s ...erty 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 /> o7/77 orized Agent=i.0j'ur- Date (Revised 4/201 <br />