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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 /> SITE ADDRESS:(��� ������ND ble PROPERTY TAX# P RMIT# 12— <br /> 005313.0838 MOO C/1, — � <br /> LEGAL for new construction: Short Plat/subdivision Lot No, (attach copy of long legal description) <br /> OWNER C.leNafr * 12oPit f .T GKtfF(N Phone/E-mail <br /> Address (ft(02�i /-11 NG. pg.. City/State/Zip evelteTf, W/l 182-o ' <br /> APPLICANT: Owner Owner's Agent _Contractor —Contractors Agent _Tenant(must provide a letter of consent from the owner to do work In the space) <br /> CONTRACTOR RkhTo2E1) DC—A4 ..1 I R.E &O1-7 State Lic.# 1�. 5TODt2$$'f Phi City Bus. Lic.# <br /> Address 280647W 106.4% 7T f /Q.01T11%, wh 981'f 1,o Phone/Email Flo - 43143- 11105-12 <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT A-E-61(A IPP Ii>Nt'1E1/ <br /> alcllandr�®AItxand,��iwtwte(deyi rt.c.owv. <br /> Phone/E-mail <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK # /DO /OM <br /> Existing Use of Building L)V - HEAT SOURCE: <br /> Proposed Use of B ilding 4If'12- Gas„_ Electric .l Other <br /> Building type: V Single Family _Duplex Townhouse _Multi-Family _Commercial <br /> Type of project: New Ac ion Remodel _Repair T.I.^Sign Sprinkler_Demolition Change of Use <br /> DESCRIPTION OF WOR tonal space provided on the back): <br /> tDONSTQue-1ii0N OF htnrkt,C TO)tY itPDITlILO itf►wYt2.0re C1C(yTWA 4(Autt, FAU4.(t y R-E 1PENGE <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 handlin• units 2. Toilet <br /> Forced air systems i Bathtub <br /> Gas piping Lavatory(wash basin) <br /> Water heater ( Shower <br /> Gas fireplace Kitchen sink&disposal <br /> Gas range Dishwasher <br /> ( Clothes dryer I Clothes washer <br /> Range hood Water heater <br /> 3 Exhaust fan I 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 I SUPPRESSION SYSTEM Other: <br /> Number of Heads Other: <br /> 1 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 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 /> •� .441A0/ - s ' P I,C. 612`f 1) <br /> Mk/nor/Au hnri -A Anon+q nnafn a rlafa MovicaA <br />