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PERMIT APPLICATIA <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: /726 n �, /n i e� PROPERTY TAX# PERMIT#` <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of!Ong legal description) <br /> OWNER joks n y7ker- Phone/E-mail 425 2)0 3€ • <br /> Address 1.7 213P-(%t I t11 City/State/Zip E-f erv4 c' Vic.. 8 2.0 1 <br /> APPLICANT: Owner Owner's Agent _Contractor* Contractor's Agent _Tenant(must provide a letter of consent from the owner to dp work In the space) <br /> CONTRACTOR 1-)G1 1 ]4(c.) Co Zek State Lic,# * r Bus. Lic.# <br /> Address (�O 2D - ��7' �f) /)"j, ..S X / i:-C_ Phone/Email ?CL,frl+ti c q� 7115 <br /> I LNAN I UUSINtbb NAME CONTACT FQR PERMIT �,'�-_1,,it et) 225339-3'i i 7 <br /> Phone/E-mail locAC�ti11c-�r 60> M <br /> �- � <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK (9% <br /> Existing Use of Building HEAT SOURCE: <br /> Proposed Use of Building Gas_ Electric Other <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(additional space p ided on the back): <br /> (Leb v; I AXI s4I (10 rc— (4,)o .5 e. -te t ;elm-0_9 (LepfcAcePtA(s (W issin ) <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type of Project: _New_Adds __Alteration_Repair Type of Project: _New_Addn ,^Alteration_Repair <br /> Show Number(#)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 I 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 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 autho'ed by the owner of this property to perform the work for <br /> which application is made and I comply with the State Contractors Law 18.27 RCW and 296.200A WAC. <br /> 9//i57/ <br /> Owner/ thorized Agent Signature Date (Revised 4/2015) <br />