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411) <br /> S <br /> 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 ADDRESSi/f 6 6* c •�® PROPERTY ra� PEb n q—bl, IY <br /> t <br /> LEGAL for new construction: Short Plat/subdivision_ l No. (attach copy of long legal description) I <br /> OWNER 7. a iel / Phone/E-mail <br /> Address .34-�o- 91 City/State/Zip A 'L,�/J2ij WA <br /> APPLICANT: Owner Owner's Agent Contractor Contractor's Agent Tenant(must provide a letter of consent from the owner to do work i hie ss <br /> 0/30 <br /> CONTRACTOR... Goy -rgeleri i) State Lic. CI 5qa City Bus. Litt <br /> Address . 0' - 7 �Piz,�"�" �A, O2) &)Phone/Email <br /> TF.N�4P� �eNF Y C' ✓ CONTACT FOR PERM <br /> 7IITT /,,f <br /> e- f <br /> Phone/E-mail IAA <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORkr/ /J4—/ 3 �XS cZ <br /> Existing Use of Building HEAT SOURCE: <br /> Proposed Use of Building Gas 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 /> /42 <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 /> A/C-air handling units Toilet <br /> Forced air systems i Bathtub <br /> Gas piping Lavatory(wash basin) <br /> 4 Water heater ( Shower <br /> ti Gas fireplace f Kitchen sink&disposal <br /> Gas range Dishwasher <br /> I' Clothes dryer Clothes washer <br /> Range hood <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 f this property to per? e work for which application is made and I comply with the State Contractors Law 18.27 RCW and 296.200A WAC. <br /> er/A riz g t r ture ate 17 (Revised 9/2014) 12,..T <br />