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*PERMIT APPLICATIA <br />BUILDING/MECHANICA,L/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: �, ) <br />PROPERTY TAX # <br />P RMIT # <br />LEGAL for new construction: Short Plat/subdivision_ Lot No. (attachcopyof long legal description) <br />OWNER ahn o ro eff;eS - <br />Phone/E-mail 7,�-%D-Y&W <br />Address '49.0 , e)DX 11!�3 <br />City/State/Zip jF—Weq— &,/¢ 9,2d <br />APPLICANT: Owner _ Owner's Agent Contractor Contractor's Agent _Tenant (must provide a letter of consent from the owner to do work In the space) <br />/_ <br />CONTRACTOR , e s 1 % erA�cSs _ktC State Lic. #�a N�vSif�983 [�(� City Bus. Lic. # <br />70 <br />Address f.D . ,z),c tee% Ba2� 3 Phone/Email *STENANT <br />BU51RM AM <br />CONTACT FOR PERMIT C� �h1,60� <br />v <br />�{ ��// <br />cas "'"l 60�� <br />670 SaT;��C441'e <br />Phone/E-mail Sa8-� <br />BUILDING PERMIT APPLICATION <br />CONTRACT PRICE OF WORK i Dpu <br />Existing Use of Buildin 2 a HEAT SOURCE: <br />Proposed Use of Building Gas Electric Other_ <br />Building type: _Single Family _Duplex _Townhouse _ Multi -Family �P( Commercial <br />Type of project: _ New Addition Remodel _ Repair Y T.I. _ Sign _Sprinkler_Demolition_Change of Use <br />DESCRIPTION OF WORK (additional space provided on the back): J <br />conae+e S/a,6 %rr 0- 19dJ 1d-+f9'• <br />Ctv,S-frL)a <br />o(ASad e qPex:sf:n 6v, Idj;�5 <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 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 (inside bidg) <br />Unit heater Urinal <br />Boiler <br />Drinking Fountain <br />Refrigeration <br />Floor drain <br />Woodstove <br />Grease trap <br />Ducting <br />Roof drains <br />Other <br />Medical Gas <br />SPRINKLER <br />/ SUPPRESSION SYSTEM <br />Other: <br />Number of Heads <br />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 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 />uthorized Agent Signature Date (Revised 412015) <br />� Z <br />�0/h <br />