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411 <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 /> S3ct)3 RITE 1/(/cS 'C�QccWitt, �OO1Cj�ESS: PROPERTY TAX# PEtAt g <br /> f <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> OWNER Fd7eehII. C6mfC.re/4 / Phone/E-mail <br /> Address 003 INes,e- CozSe r eva City/State/zip Ev' : (.4.o /q. <br /> 8 ZD,y <br /> APPLICANT:_Owner _Owner's Agent Y.Contractor _Contractor's Agent _Tenant(must provide a letter of consent from the owner to d sOice) <br /> l' i <br /> CONTRACTOR#4ar�'fS Ng f J'A/ State uc# 14 'R X(7 t t $SAP City B s.ur#Oc3212- <br /> Address Phone/Email <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT <br /> j� <br /> �j .Sly awl, 144t.( /g Sa3-87?'-066,b <br /> 50 h r� 4/6 5O ��F `n p`',�/`v''2- Phone/E-mail Sn't ck.(fltel Seket r— 4 4.,#r C OArf <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK 1. - �• <br /> Existing Use of Building A-11/1 HEAT SOURCE: 7 ' / <br /> Proposed Use of Building Pall el / ./`ftt Gas_K Electric /C, Other__�(J <br /> Building type: _Single Family _Duplex_Townhouse _Multi-Family ><Commercial <br /> Type of project: 54 New Addition Remodel Repair_T.I. Sign Sprinkler Demolition Change of Use <br /> DESCRIPTION OF WORK(additional space provided on the back): L)e- we_ fhe- clef Brae e p,t7104t,Io✓, <br /> toe, 'Lc,'(( Q c- /&s 4 q ((/N, ducfwor k c osoc.�4 �cd tvei- - 3 ct..lt d <br /> a.(taur 1.4)t444 er-S/, ,S"Z, �tpV-- 6 c u.e( V4v-C6. 14Ise / wQ,-feh, 4ea,*cv (k.qt <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type of Project: 3 .341ew Addn Alteration_Repair Type of Project: New_Adds Alteration_Repair <br /> Show Number(#)of fixtures Show Number(#)of fixtures <br /> NC—air handling units —b 0t1'f 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 - p t,c f' (y 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 V D'r V fa,ye 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 a thorned 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 /> Owner/Authorized Agent Signa re Date (Revised 9/2014) bt-1/ <br />