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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 /> SITE ADDRESS: PROPERTY TAX# I p )Zlyl J ' <br /> qo/ ,6O(k+F /er AIX- 001,131749101-100 /D rA i,'� <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> OWNER f2 ie Cole 4 Phone/E-mail `fS^ 2230- '70402,0 <br /> Address LAO/ AOCif Tell /l/p_ City/State/Zip L1Ql(it5WA- /&2Q/ <br /> APPLICANT:_Owner _ //Owner's Agent 'Contractor _Contractor's Agent _Tenant(must provide a letter or consent from the owner to do work In theemspace) <br /> CONTRACTOR 5O/.11e %C-4-4,/,Ctf/ State Lic.# /ems- q/50,1" City Bus.Lic.#05330 J <br /> Address aOO 5-e-C 6 e td a(pc__ 622J-2.2,14 cot. Phone/Email r,206, 59‘,, L-710 <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT <br /> Phone/E-mall -J-e�1JOLAP ��� �^�y®/ <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK <br /> E)dsting Use of Building HEAT SOURCE: <br /> Proposed Use of BBBuilding Gas V ElectricOther <br /> V <br /> Building type: Single Family _Duplex Townhouse _Multi-Family _Commercial <br /> Type of project New V Addition _Remodel _Repair_T.I.—Sign Sprinkler Demolition Change of Use <br /> DESCRIPTION OF WORK(additional apace provided on the back):/ <br /> e Moiled , L.i '/o 0-1-1-w? �tOt-c , �dk.,0.� ut e c t>.C�� �sz-- <br /> O <br /> 124-,& <br /> MECHANICAL ERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type of Project: New Addn ZAIteration_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 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 /> t <br /> Number of Heads Other. <br /> I hereby certify that I have read and examined this appkcathm end know the same to be true and correct.All provisions of laws and ordinances governing this type of work Mill be comp <br /> with whether specified he or not.The granting of a peon does not presume to give authority to violate or cancel the provision of any other state or local taw regulating canobuction <br /> That I am authorized by owner pro . fthe work .r which application is made and I comply with the State Contractors Law 18.27 RCW and 288200A WAC. <br /> 4, / ,/a ` AHD.�'! <br /> Owner/Authorized A Signature Date (Revised 8/2014) <br />