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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# PERMIT# <br /> `310a3X5/4Ave.,6 LUA 'RI ROI I0045totl0\\00 <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> OWNER SuoAcirer4 SokKpal <br /> a jt- Phone/E-mail 1 <br /> Address o�-15 NW (btQ&To.�.2. P� .1/4-19/1V'c City/State/Zip 3QX.1/4-19/11-)( `"l <br /> ( lOt,kQ <br /> APPLICANT:_Owner _Owner's Agent X. Contractor Contractor's Agent Tenant(must provide a fetter oof consent from the owner to do work in the space) <br /> CONTRACTORa'( c1 TI(,tvwti tytC State Lic.# LZCCIC PlY31.�3'y Bus.Lic.# 51.754 <br /> Address 6q00 (s S&"J 'kk91/M Ad(5) Phone/Eman_ v amt s ek p Iwo Q tJ ho, <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT 1t <br /> t(�-Fi u1 5ov - <br /> Phone/E-mail lias-.9$5"DSat bi+t k A ekot elialI&.CCI;+t. <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK a pi DDO. OP <br /> Existing Use of Building k)Q�1.0 CS' '(Lae\l 0i1,, HEAT SOURCE: <br /> Proposed Use of Building 3-04)x 1tc(slitLtt Gas Electric Other <br /> Building type: _Single Family_Duplex Townhouse /t 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 /> Adria l oo f'(oi s >jh k a .56040€ 014Lei tc_ 61,tiL ?Cf 7(D- eel <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION I <br /> Type of Project: _New Addn Alteration_Repair Type of Project: New Addn Alteration_Repair <br /> Show Number(#)of fixtures ow 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 g« <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 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 1827 RCW and 296.200A WAC. <br /> (UJL 7/ V// <br /> Owner/Authorized Agent Signature Date (Revised 9/2014) <br />