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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 ADtJRESS: / PROPERTY TAX# PERMIT# <br /> LEGAL for new construction: Short Platt//subdivision I ZOZ' O/lv- 6 Lot No, Z-. (attach copy of long legal description) l <br /> OWNER /41,,h1,24/ Lantd e ri0/Q?/feit Phone/E-mail "Z�Y-4/0f ,/JAM 4)5,7141"-AD/44"A./ <br /> Address/a &)( /2J77 City/State/Zip ,' //c' 1kle L 4/# 9&Q rel--- <br /> / <br /> APPLICANT: (wner Owner's Agent Contractor Contractor's Agent _Tenant <br /> (must provide a letter of consent from the owner to do work in the space) <br /> CONTRACTOR ..5-/;/1‘a..../ <br /> Airc ,44,'rj /! !/A L&I Lic.#516-4)4/ *//7,r . COE Bus. Lic.# <br /> Address!V 4y. /Z /6 ,fi //��?e4, 444 1 z ��i '0%.019 <br /> Phone/Email <br /> TENANT BUSINESS NAME CONTACT NR P RMI <br /> Jot.•. YVLi -t .�/ <br /> Phone/E-mail c(lj-2.01-05-V9 <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK 90,5 ,972 , <br /> Existing Use of Building HEAT SOURCE: <br /> Proposed Use of Building 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 /> 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 I <br /> A/C–air handling units 4 I Toilet <br /> I Forced air systems 3 Bathtub <br /> L I Gas piping S 0 j Lavatory(wash basin) <br /> I Water heater I Shower <br /> I Gas fireplace I Kitchen sink&disposal <br /> 1 I Gas range ( Dishwasher <br /> 1 Clothes dryer ( Clothes washer <br /> I Range hood L_--- _[_ _ WeWheater <br /> 1 Exhaust fan I Sink(service/bar/mop/etc.) <br /> Heat pump Backflow preventer <br /> Unit heater j Urinal <br />! --7 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 /> 1 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 specified herein or not.The granting of a permit does not presume to give authority to violate or cancel the provision of any other slate or local law regulating construction <br /> That I am- •'zed 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 /> 4 4 <br /> /2A—Owner/Authorized Agent Si natureRevised 6/( za,2) (z9 <br />