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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 _ DRES PROPERTY TAX# PERMIT# <br /> iriD1 �rt VAhark )rr>y-7-) 000.i-oo L- 13 I I"00et" <br /> LEGAL forornew construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> OWNED /1 rj1 ie KI3+ Phone/E-mail 6:7 'aj-S 4 14 f'�'1.Tc ie �� <br /> Address 1 DogR.66_ City/State/Zip Nit , ,1-k,6 Atka Yi c 4a./- <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 )I kir}' 1"� State Lic.# City Bus. Lic. # <br /> Address L Phone/Email <br /> TENANT BUSINESS NAME C311TaCT R PERMIT <br /> Phone/E-mail h(AA., \-\_6_.(4.. . ..'49.3 .p Q L t( --t_ <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK Of OoOf OGIO <br /> Existing Use of Building r,• - HEAT SOURCE: <br /> 7 <br /> Proposed Use of Building ie5ke k w Gas Electric V Other <br /> Building type: Single Family _Duplex Townhou Multi-Family Commercial <br /> Type of project: New Addition Remodel V Repair T.I. Sign_Sprinkler_Demolition_Change of Use <br /> DESCRIPTIONC-eOFA WOfjJ`C`�ditionalspa�eprovided thitiack): 053 f • t/\•Q� ) 1 , 0` <br /> ICL <br /> 0# • 1 <br /> ECHANIC , L 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 I i/ j Bathtub <br /> Gas piping I // j Lavatory(wash basin) <br /> Water heater i/ j Shower <br /> Gas fireplace I m•es‘ j Kitchen sink&disposal <br /> Gas range I c7 j Dishwasher <br /> Clothes dryer ! Clothes washer <br /> I Range hood j Water heater <br /> a ✓ Exhaust fan j Sink(service/bar/mop/etc.) <br /> Heat pump Backflow preventer <br /> Unit heater Urinal <br /> Boiler j Drinking Fountain <br /> Refrigeration j Floor drain <br /> Woodstove ! Grease trap <br /> j Ducting j Roof drains <br /> Other Medical Gas <br /> SPRINKLER / SUPPRESSION SYSTEM Other: <br /> j Number of Heads j 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 complied <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 d 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 /> 1.1z <br /> 11 a.()13 <br /> Owner/Authoriz d Agent Signature bate (Revised 3/2013) <br />