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PERMIT APPLICATION <br /> BUILDING/MECH•CAL/PLUMBING/SIGN/SFNKLER/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: c-, , _- . PROPERTY TAX# PERMIT# <br /> C--. ( E- ( l ti--/CLC.,;�> 00/, -5fZ oo/u0 00() t'\1`.)( _ C" -. <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copyoflong legal description) <br /> OWNER -/���� ��17/11 , v7///e/--7-\/ Phone/E-mail 772.-2>5 CF, qz z z�/ <br /> Address fD ZC�/� /j �7 City/State/Zip a'-c //J / 9? / <br /> APPLICANT:,X Owner Owner's Agent _Contractor _Contractor's Agent Tenanty (must provide a letter of consent from the owner to do work In the space) <br /> 9NDCONTRACTOR / GA� /-tlrntState Lic.# ' �s! - tct IU I Z City Bus. Lic.# <br /> Address Phone/Email <br /> TENANT BUSINESS NAME� / CONTACT FOR PERMIT4a�zr Y /76L��/t <br /> g/7/vl� � / Phone/E-mail z 2 93 --6 i..? T-;eT <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK /60 O. 4M <br /> Existing Use of Building 5–A---)e HEAT SOURCE: <br /> Proposed Use of Building 5F/e Gas X ElectricOther <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 /> 0/ Vt CC Am <br /> f nC-e + ko t vt)- --etk,i'e <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(4)of fixtures Show Number(4)of fixtures <br /> A/C–air handling units I Toilet <br /> / Forced air systems ( Bathtub <br /> Gas piping Lavatory(wash basin) <br /> r 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 comp) <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 autho'zed 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. <br /> "� t 7/6. <br /> 1 <br /> I 4/2015 <br /> Owner/Authorized Agent Signature Date (Revised ) <br />