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I 1-.1 %1 V 1 1 1 r-1,1 I L.1 V%-t 1 ■NI/1 ‘ <br /> BUILDING/MECONICAL/PLUMBINGISIGN/WINKLER/DEMOLITION <br /> CITY OF EVERETT PERMIT SER .SES <br /> 3200 Cedar St., Everett, WA 98201 425-257-8810 FAX 425-257-8857 www.everettwa.org <br /> SITE ADDRESS: PROPERTY TAX 4PERMIT# <br /> `C LI C 1 (1c4-) oo7<r .. ' Cl/.2' t v' v 11 1(_; ( - C--_t- j <br /> LEGAL for new construction:��/ �Shhort PlaUsubdivision • Lot No. (attach copy of long legal description) <br /> -V�/c�� f�"U <br /> OWNER eh- �U <br /> //J Tf74/e, \ Phone/E-mail -V2 525-767, g z z- <br /> Address t‘')ze)x /s----Z'/7 City/St3te2ip&---- ---,-E77-.4/74 9? 0/ <br /> APPLICANT:X Owner _Owner's Agent _Contractor _Contractors Agent _Tenant(must provide a leper of consent from the owner to do work in the space) <br /> CONTRACTOR /9/40G99/ State Lic.# D't5A'*- k°1 Iv) Z City Bus. Lic.# <br /> Address Phone/Email <br /> TENANT <br /> �JBUSINESS <br /> �NAME CONTACT FOR PERMIT /g/ii y '6Z 771/6— <br /> gr/ <br /> j)/f <br /> gr/I , v / `� Phone/E-mail 2/`s- 293 56 i_j Tom, <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK /6.0 D. <br /> Existing Use of Building J`!/�� HEAT SOURCE: <br /> Proposed Use of Building 5-F/e Gas A 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 /> v ISL c-c r nk C-v <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 Ni)of fixtures Show Number(#)of fixtures <br /> NC-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 cot <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 stale or local law regulating construct <br /> That I am authors by th "fr of this property to perform the work for which application is made and I comply with the State Contractors Law 16.27 RCW and 296.200A WAC. <br /> t <br /> Owner/Authorized Agent Signature Date (Revised 4/2015) <br />