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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 /> SITE ADDRESS:-1-112.14 <br /> _2.1 1 qt-11 VC/ se <br /> PROPERTY TAX# <br /> LEGAL for new construction: Short Plat/subdivision 1M IVK ittivrts Lot No.1\11-(attach copy of long legal description) <br /> OWNER <br /> (tea,/r/II <br /> OWNER S PC((;(t c, t S Phone/E-mail Li 9_5615-2, ers /� (� <br /> Address 1'10 \tJ c �{T w'ci \1\-Vol-t+ i IOD City/State/zip Cv.e�( '�-Ic 1, 'AJ -• 125 2,04 <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(4611(/)raced plum hl y>a ,K12,611--- State Lic.# MANI PL( 176-city Bus.Lic.#O )24'2? <br /> Address(2Z e,ic�' �'%a 4Q, SA{I ' I/r S►�.C�i6W'1 is frit v�'14 Phone/Email `�i5-�J-I R-5 I Co • <br /> TENANT B. ESS NAME CONTACT FOR PERMIT Vic*hip, 'lzs_703 -2599 <br /> Phone/E-mail 425 S g 5 l O C) <br /> BUILDING PERMIT APPLICATIONS CONTRACT PRICE OF WORK $ 43t7. CO <br /> Existing Use of Building HEAT SOURCE: <br /> Proposed Use of Building 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): t —OLE ( <br /> OJCpcCe <br /> 1/)/1 <br /> — u ( 5a PP -moi C2r7 �-� <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 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 <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 /> I L 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 comp) <br /> with whether specified terem or not i he granting of-a perrnirdoes-notpresume-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 298.200A WAC. <br /> a%' //t /7 Z//6 <br /> Owner/Authorized Agent Signature Date (Revised 9/2014) <br />