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et) <br /> ERMIT APPLICATIO <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 /> q APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> SITE ADDRESS: 34D �0(...K� E.� ag. AVE., 00459 (a54-t�1 tk PROPERTY t 7 PERMIT1 j <br /> � _ f�I �L k;: - <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of longnglegal description) <br /> OWNER 1 ST F'RE58�`T ERI��I G+�uRC Phone/E-mail 4'25' 25 G{1 _f 19 <br /> Address 2 q-5(.4, O C K + E,LLEA& itci E. City/State/Zip e. / Tc f w A t q E 20 <br /> APPLICANT:,_.Owner )K,Owners Agent Contractor Contractor's Agent _Tenant(must provide a letter or consent from the owner to do work in the space) <br /> CONTRACTOR U VV f(?{ L& I Lic.# COE Bus. Lic.# <br /> Address Phone/Email <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT Ti-+ol�tr� p <br /> jt_ I l S <br /> (1914\? Phone/E-mail "1'4�•�'2Scl"3\ -1-440110.514e DY►��MAa� �rJ�T <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WOR <br /> Existing Use of Building HEAT SOURCE: <br /> Proposed Use of Building Nu2CGas Electric Other <br /> Building type: Single Family Duplex Townhouse _Multi-Family x Commercial <br /> Type of project: New _Addition ,Remodel Repair T.I. Sign Sprinkler Demolition Change of Use <br /> DESCRIPTION OF WORK(additional space provided on the back): F Ir p � ��}�e E LE,61'421GA&, S 1 VtC F W lrN <br /> i,‘rcLA) EQVt1-1.5-1T Ai1D coNSTgLIcT OVA) fs1, -r CA(.... CUDseT. <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 /> 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 /> 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 compiled <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 296.200A WAC. <br /> � 1176/2(,/, <br /> ner/Authorized Agent Signature Date Revised 6/2012) <br />