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• <br /> PERMIT APPLICATION <br /> BUILDING/MECHANICAL/PLUMBING/SIGN/SPRINKLER/DEMOLITION <br /> CITY OF EVER TT PERMIT SERVICES <br /> 3200 Cedar St., Everett, WA 98201 425-257-8810 FAX 425-257-8857 www.everettwa.org <br /> SITE ADDRESS: PROPERTY TAX# P IT# <br /> / /9/ HAD,fe/t 9) ��U�i'E 1�8.M3 ©esds'700 o6.3.?S/ . I'3 0 00 <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> ,44-e /tie ymIfs _ _ <br /> OWNERS .1� A �N�N M f� '/t Phone/E-mail f2,5"--– -6O <br /> Address /f/e7/ /21/719Nd4//9 City/State/Zip T v6/pt- i(/ s- r".61.3 <br /> APPLICANT:—Owner —Owners Agent,KContractor _Contractor's Agent _Tenant(must provide a letter of consent from the owner to do work in the space) <br /> CONTRACTOR 1 I3 AT,0 rJ� A State <br /> Lic.Li #�/J/4/gb 7 x-pot sap City Bus.Lic.#. 7776 9 <br /> Address /,R y/t/ �9? UN/r o Ciebrrr (62tf Phone/Email 9.2 r-/�0"Q�osO <br /> TENANT BUSINESS NAM CONTACT FOR PERMIT G'11 e7 Eibt'Vey <br /> V2 97/-ire 4 <br /> Phone/E-mail /NFOf/� Co.0ST#QI/C7(p 1).GD/1.BUILDING PERMIT 2y �' <br /> • <br /> Existing Use of Building tCQAPPLICATION CONTRACT PRICE OF WORK /eE-5/0e/t)C - HEAT SOURCE: <br /> Proposed Use of Building It e-5/0t' d/C F Gas_ ElectricOther <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(additio I space provided on the back): <br /> /3u, 7 Rtf 4 fi`d'e t /7- 'CeRit) 11/ere) <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 i Backflow preventer <br /> Unit heater Urinal <br /> Boiler Drinking Fountain <br /> Refrigeration Floor drain <br /> Woodstove j 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 tole and correct.All provisions of laws and ordinances governing this type of work will be comp' <br /> wither 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 authorized b the o r of thi roperty 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 /> •er/Authorized nature Agent Signature g Date (Revised 92014) (Z <br />