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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# E T# <br /> 2502 Ur'CTolz Pc co553/co zoo ?ty / O tb 10- 00 9 <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of longnglegal description) <br /> OWNER P14-2 EV ACret /F3'Aor'1 / Cy Phone/E-mail 5 3S/ c1'Z V <br /> Address /92o5 ye' AV W City/State/Zip L,yNNWa7A, Ce//4 960 56. <br /> APPLICANT 'S Owner _Owner's Agent _Contractor _Contractor's Agent _Tenant(must provide a letter of consent from the owner to do work in the space) <br /> CONTRACTOR 61,u no( State Lic.# City Bus. Lic.# <br /> Address Phone/Email <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT <br /> Phone/E-mail <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK <br /> Existing Use of Building k/5/1 /4 Si HEAT SOURCE: <br /> Proposed Use of Building Res/464"4-6 S Gasx 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 provided on the back): <br /> ?vier A N $ 2 5 tey S/N616' /CY fi&ciE <br /> w /&Aschl/u-r- . <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type of Project: New_Addn _Alteration_Repair Type of Project: 71•New_Addn _Alteration_Repair <br /> Show Number(#)of fixtures Show Number(#)of fixtures <br /> A/C—air handling units Cf Toilet <br /> / Forced air systems 2. Bathtub <br /> Gas piping Lavatory(wash basin) <br /> Water heater I Shower <br /> Gas fireplace / Kitchen sink&disposal <br /> / Gas range / Dishwasher <br /> Clothes dryer / Clothes washer <br /> / Range hood _71-- Water heater <br /> 6 Exhaust fan / 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 comp <br /> with whether specif .here' 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 a .. �. .,, this property to perform the work for which application is made and I comply with the State Contractors Law 18.27-CW and 296.200A WAC. <br /> iffPf .lr'4°"r Pp -0 t- 15 <br /> 0 • •r/Au• •rite• •gent Signature Date j/ L Revised 4/2015) <br />