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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 vnvw.everettv/a.org <br /> SITE ADDRESS: PROPERTY TAX H PERMIT a <br /> -3of4.-kJ fc,- Ave_ + vJ 91-2-P/ _ voy39,'{9242aSoo C'ico g-OOg <br /> LEGAL for new construction Short Plat/subdivision Lot No (attach copy of long legal description) <br /> OWNER S2 Gra✓p .T•4-4.— Phone/E-mail 2a 4 12-7-3s s 3 541,21,4j1 '-c.. rc%.cnir <br /> Address N-73 7 C„!3✓C e., P>f eel/. ,i_..Z...toe_t414 City/State/Zip M c.f. .t'- w A j 1'D 3 ” <br /> APPLICANT: 1t Ov.ner _Owner's Agent _Contractor _Contractor's Agent _Tenant(must c.c.,o.a loner of consent from e,•over to so wort n,e scar. <br /> CONTRACTOR N/A State Lic.# City Bus.Lic.# <br /> Aadress Phone/Email <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT <br /> 5ct. ' F/ c-'- <br /> Phone/E-mail ZOL LZ7 3 j 34 STEL-Tc-k IflLoo/.c.t•w <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK ai n? <br /> Existing Use of Building YS—Q HEAT SOURCE: <br /> Proposed Use of Building S/-"- Gas X Electric Other <br /> Building type: .0 Single Family _Duplex_Townhouse _Multi-Family _Commercial <br /> Type of project: New Addition ,[Remodel Repair_TT_Sign Sprinkler_Demolition_Change of Use <br /> DESCRIPTIONpOF WORK(additional space provided on the back): <br /> /2 r.4*od e.I �. -}-c_ke-4" ltls 4 Ams-41,(00/riS. <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(H)of fixtures Show Number(#)of fixtures <br /> A/C-air handling units 3 I Toilet <br /> Forced air systems Z Bathtub <br /> - <br /> Gas piping 1/ Lavatory(wash basin) <br /> / Water heater Z. Shower <br /> I Gas fireplace I Kitchen sink&disposal <br /> i I Gas range / Dishwasher <br /> Clothes dryer I Clothes washer <br /> /I Range hood Water heater <br /> I I Exhaust fan Sink(service/bar/mop/etc.) <br /> Heat pump Backf.ow 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 I Medical Gas <br /> SPRINKLER ! SUPPRESSION SYSTEM Other: <br /> Number of Hee& ; Other: <br /> I hereby certify that I have read and examined this application and know the same to be into and correct All provisions of laws and ordinances governing this type of work will be comp <br /> wit whether specified herein or not The grantng of a permit does not presume to give authority to violate or cancel the provision of any Other state or beat taw regulating construction <br /> Thar I am authonled be rot this p to perform the work tor which application is made and I comply with the State Contractors Law 18.27 RCW and 296.200A WAC <br /> .e — gay <br /> „,i;)()Ls <br /> Owner uthorized Agent lure / t(. <br /> 9 ���- (Revised 4/2015) <br /> \iZ <br />