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• • <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 ADDRESS: PROPERTY TAX# PERMITIIT��_ <br /> (32.1 Co l fi v.e LI <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> OWNER 4 tt7VW.B (.�,t b�50#z '(e b i5 Phone/E-mail C.2 . ss <br /> arar <br /> Address e' r x 24 gg.0j City/State/zip S'EA-!'TLC ,WA 041124 <br /> APPLICANT: Owner X Owner's Agent _Contractor _Contractor's Agent _Tenant(must provide a letter of consent from the owner to do work in the space) <br /> CONTRACTOR Lif".444eaS414 Qj N Pi1.0 1/Oef-.S State Lic.# N yfi lc/ K3 City Bus.Lic.# 01-t.j6�S <br /> Address Phone/Email <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT -MN((i( • A: (o- <br /> DY �4G� m tG�,• C`�-25�2��J• b86$ <br /> Phone/E-mail devi n cs bt7 har4r41.Gam <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK 4 1 489 6t O. oO <br /> Existing Use of Building M' i'(Gkt.•GL(W(G r 13` 4.I.GUr .GY HEAT SOURCE: <br /> Proposed Use of Building tBt Gas x Electric Other_ <br /> Building type: _Single Family —Duplex_Townhouse _Multi-Family _Commercial <br /> Type of project: New Addition Remodel Repair X_T.I. Sign Sprinkler Demolition Change of Use <br /> DESCRIPTION OF WORK(additional space provided on the back): <br /> tc-4-tr .cr1 moc—rCrc t. at4V j7-6M617EC, aelf Vc( c1Gr 14 42.5 s • -ra <br /> VIEW M,Et7V4se(. Gt.t(--itG obi 1146 114egV• e= 114e <br /> 1yxt�3(Zl�Lrw MMt7(Ciset• G.L(NtG 'vtiWVt“ ,. <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 Shower <br /> Gas fireplace Kitchen sink&disposal <br /> Gas range Dishwasher <br /> Clothes dryer Clothes washer <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 compl <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 thi roperty 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 /> clAuthoidget Signature Date (Revised 9/2014) I/2. <br />