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. I ER <br /> MIT APPLICATI <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 /> OM 1561. 1C0'2 <br /> SITE ADDRESS: PROPERTY TAX# PERMIT# <br /> Z24 01---ILL .�T £v'-r- o0(Po6)3ooc 30oo . <br /> LEGAL for new construction: Short Plat/subdivision•,Jt£U) g061 APO DR/ 3 Lot No.30 (attach copy of Tong legal description) <br /> OWNER L'gon. ,A),-W( le/T._ Phone/E-mail <br /> Address 022, S0-at._ ST City/State/Zip <br /> APPLICANT: +/ wner _Owner's Agent _Contractor Contractor's Agent _Tenant(must provide a letter of consent from the owner to dp work In the space) <br /> CONTRACTOR State Lie.# City Bus. Lie.# • <br /> Address • Phone/Email <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT <br /> Cif 09121-05 /U."(A)e_ br <br /> Phone/E-mail 9 .3' ,2.. -9 4Y • <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK 50 0 O. <br /> Existing Use of Building 1/0(.71--C.. F4M It-'f Or....S HEAT SOURCE: . <br /> Proposed Use of Building 5A-/L4 Gas_ Electric Other_ <br /> Building type: v 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 /> gat/AOV I.-- 4 >& V/ o vS 6 Lou Eg. Vit?nArabc.L. ArAo RPP wl t t'/ <br /> i'LJmg►1 <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 f Shower <br /> , I Gas fireplace Kitchen sink&disposal • <br /> Gas range Dishwasher <br /> 1 Clothes dryer I Clothes washer <br /> Range hood Water heater <br /> • 1 Exhaust fan 1 Sink(service/bar/mop/etc.) • <br /> Heat pump Backflow preventer(inside bldg) <br /> Unit heater Urinal <br /> Boiler Drinking Fountain <br /> I Refrigeration Floor drain <br /> Woodstove Grease trap <br /> Ducting Roof drains ' • <br /> I 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 complied <br /> with whether sp -d herein r not.The grants 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 --'auth• ,by the er of this prop y to perform the work for which application is made and I comply with the State ntractors Law 18.27 RCW and 296.200A WAC. <br /> 7/ 1` s <br /> Owner Authorized nt Sig atu Date // // (Revised 4/2015) <br />