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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 /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> SITE ADDRESS: PROPERTY TAX# P MIT# <br /> 333:2 //e.-- yrs.= 00Y36 9792 0/ 7oi i 3Gui -U0-7 <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> OWNER CA.,";f P/70q �i Phone/E-mail °"2S —32g— 6 S g 7 <br /> Address 3332 /4�(,/FT/+T.fiC'/ Q, c' City/State/Zip E,,/e.,..)„,,77- 414 'Z'20? <br /> APPLICANT:_Owner _Owner's Agent _Contractor I0 l ontractor's Agent _Tenantn (must provide a letter of consent from the owner to do work in the space) <br /> CONTRACTOR SLdl Jto , /—. -,.'j /, L&I Lic.#SAeJ F/.92©R7 COE Bus.Lic.# 7 <br /> Address pa- i /� ✓ - <br /> r -J4/Jfe O .I-idAo-�- -j Phone/Email /2 J.Zd'•-6 c 9 7 <br /> TENANT BUSINESS MAMECONTACT FOR PERMIT <br /> /�� S G o /- v ° ("41z; <br /> w v' l'.Z S'-32g -�'s 97 <br /> Phone/E-mail /Y1 S (-,/. o Co-,.rt sr 9:lL,,v e 7 <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK .4 0 0 0- <br /> Existing Use of Building a 4,-k, G'. ‘,/-1 HEAT SOURCE: <br /> Proposed Use of Building //Zc/r Gas Electric Other <br /> Building type: Single Family _6uplex_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 provided on the back): ,- e1--'v v e e-x'.'S'f'n� . go---.0 f <br /> Gfoe-6 - HePrd G . W,7Z /7e ' r c/ec,* S' <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(#)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 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 I Other: <br /> Number of Heads I 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 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 /> ,te r _4r4sLyr4-1" St/ <br /> Owner/Authorized Agent Signature Date (Revised 6/2012) <br /> `i' <br />