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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 /> ,SIT ADDRESS: • 0 . PROPERTY TAX# PERMITV# ,1 'O <br /> r <br /> /40 (2 / /-,I/ 6, , <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> OWNER 'f of Ileu5/,u c 4i % i itY Phone/E-mail 1-:„7 c�30". ,-�/ / <br /> Address S�'� r • / City/State/Zip ^ A gaol; 0/ <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 RJr• .CjT e (;o_, itbzcD'i,) State Lie.# i7(,!\.c e �oz_o Ciity Bust.P-74,5-- <br /> TENANT <br /> lLii .#, a� 76 <br /> Address/ 7, 8o`zi Q 17,53) i�f iL1 U IJ � , qR0 7 Phone/Email �3— 9�)— CI /�,5-- <br /> TEjN�ANT BUSINESS� _ESNAME CONTACT FOR <br /> /PERMIT <br /> �/� / <br /> //t l'ie- t/ J 1$-/A)r 4440+7 Phone/E-mail ' / 5--- J33"//ogj k-' f 1�BUILDING PERMIT APPLJATION CONTRACT PRICE OF WORKe vL/ <br /> Existing Use ofBuilding,. rJCc) /,iV(c 4 0gs,N HEAT SOURCE: <br /> - 1 <br /> Proposed Use of Buildin•. di Gt) ) i Gas Electric Other <br /> Building type: Single Family _Duplex Townhouse A ulti-Family _Commercial <br /> Type of projec New Addition _Remodel _Repair ' T.I._Sign Sprinkler Demolition Change of Use <br /> DESCRIPTION OF WORK(additional space provided on the back): <br /> V�f�yUc 0.�, ;� aloktc,€_. l�f lata wEnv' GI fah) �.- <br /> Jn� e 34,1# t^c <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 f.// �¢, 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 I 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 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 /> io.,,.:.....r WO/1411 <br />