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f4 <br /> • <br /> • <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 ADDRESS: PROP TY TAX tt PERMIT* <br /> • n moi ( ♦ ' V 600 ' / -01 � 1 I(3 <br /> LEGAL for new construction: Short Plat/subdivision 1,.ot No. (attach mpy of long legal description) <br /> OWNER�'},(4E1 onernc-mazS=45-a...2)345 y w faet��st. - <br /> Address f t.SIOX 971,* City/State/Zip LL E/ WA-47/3/Peet-4I 54- <br /> APPLICAN T:_Owner _Owr:er s Agent _Contractor _Contractors Agent ,Tenant(must provkda a lot:or o:consort from the amor:a do xoik in the space) <br /> CONTRACTOR Yv'f).vL.Y1i —oC,v. £iA€ ,4' r� State Uc.# RAN ILt2E987CZ rCl Bks.Lk.Address C)0�.x Z 3 t"3Qaywl�.p W►4. 9S473 Phone/Email .��feint,Ecom u ,KA" <br /> TENANT BUSINESS NAMEe �, �j CONTACT FOR PERMIT <br /> T� — T/u N C/►-LI�-� Phone/E-mail AS-7-401.--t„,( 4,0 <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK 4'4r- <br /> Existing Use of Building HEAT SOURCE: <br /> Proposed Use of Building Gas_ Electric Other_ <br /> Budding type: _Single Family —Duplex Townhouse —Multi-Family 2‹,Commercial <br /> Type of project: New Addition Remodel Repair T.I. _.Sign_ Sprinkler_Demolition Change of Use <br /> DESCRIPTION OF WORK(additional apace provided on the back): Xv $4- v-e+o •c '- E Ps Fluke_ ci,ue r <br /> w«rineu,t c t,l,l •s 1-etnc GA-F R-1n&o ?VC .06'o nv..:k s.,�g 1 e e[,) <br /> r0 � 5%5A--0... a,,e✓ ex. 54,NA.5 wt�'1-0a v-.0%"4. 3 4�1Uh < I F <br /> `'�j • s._.._ p <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type of Project: New_4ddn Alteration_Repair Type of Project: _New Addn Alteration_Repair <br /> Show Number(A}of fixtures Show Number(#)of fixtures <br /> NC—at 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 r, •• Dishwasher <br /> Clothes dryer Clothes washer <br /> Range hood I Water heater <br /> I Exhaust fan Sink(sorvicelbarhnop/etc.) <br /> Heat pump ' Backflow tawnier nside • <br /> Unit heater _ Urinal <br /> Boiler _ [Milking Fountain <br /> Refrigeration Floor drain <br /> Woodstove Grease Ira <br /> L)ucting Roof drains <br /> Other Medical Gas _._ .. <br /> SPRINKLER /SUPPRESSION SYSTEM Other: <br /> Number of Heads Other. <br /> I hereby malty that I hove Iced mid opantwd this upprcation and know the sumo to be Wo and correct.Al provisions of laws and ordinances governing the type of work wit be oompl <br /> with whether spatted herein or not.The granthg of a gam*does not presume to gtvo authority to violate or cancel the provision of any other state or local law regulating construction <br /> That I am authorized by the ownerof this properly to perform the work for which applicator'is made and I comply with the Slats Contractors Law 18.27 RCW and 296.200A WAC. <br /> /O//34W <br /> OwnedAuthorized Agent Signature Date (Revised 4/2015) <br />