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f <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# Pelt"IT# <br /> C(2-C , s " Cie- . eS�P tT c t 0�}.. 00(9 <br /> LEGAL for new construction: Short Platisubdivisior_S�,A 612.- c?A214- Lot No3 r (attach copy of long legal description) <br /> OWNER a.A., (., ?AL,,r tL 0,-01,4,4 S Phone/E-mail (4zs- -a? <br /> GIS'? - 2��cic.3 <br /> Address IZC S v.: a 4;c R-V_F P- A.1,.... u,: ...t City/State/Zip Ev ELI-LirL444 • Q►- ZC;4 <br /> APPLICANT: Owner —Owner's Agent Contractor Contractor's Agent Tenant(must provide a letter of consent from the owner to do work!n the space) <br /> CONTRACTOR Aja,P,TT LEE- ,A cC.i -tc 140yA es State Lic.#'52AXT P ti CrC,s i3�.; City Bus. Lie.#(.0t3 -L4,40--2 <br /> Address SI1.vKre,, Phone/Email 5A„M <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT <br /> Phone/E-mail (-QZ� ) 3-.:,-c, -- Lit:o Z-- <br /> 1 <br />' BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK <br /> Existing Use of Building HEAT SOURCE: <br /> I Proposed Use of Building Gas V"Electric Other_ <br /> Building type: ✓Single Family _Duplex_Townhouse _Multi-Family _Commercial <br /> Type of project: 1/New Addition Remodel _RepairT.I. Sign_Sprinkler Demolition Change of Use <br /> DESCRIPTION OF WORK(additional space provided on the back): <br /> 24l k_f==•-...) CZ c a (3arsk c._ RZ - l 40- _ (:,o---1 <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 /> 1 i Forced air systems Bathtub <br /> 4 Gas piping 4 Lavatory(wash basin) <br /> { Water heater ( Shower <br /> 1 Gas fireplace 1 Kitchen sink&disposal <br /> Gas range 1 Dishwasher <br /> t Clothes dryer 1 Clothes washer <br /> i Range hood 1 Water heater <br /> t D i Exhaust fan Sink(service/bar/mop/etc) <br /> Heat pump — Backflow preventer <br /> -r I Unit heater Urinal <br /> ._ Boiler Drinking Fountain <br /> Refrigeration — . Floor drain <br /> -- Woodstove — Grease trap . <br /> -- Ducting La Roof drains <br /> Other -- Medical Gas <br /> SPRINKLER / SUPPRESSION SYSTEM 1 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 end correct.All provisions of laws and ordinances governing this type of work edt 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 ars auth zed by the owner of this property to perform the work for which applications made and I comply with the State Contractors Law 18.27 RCW and 296 200A WAC. <br /> j <br /> g <br /> Owtr/Authorized Agent ignature Date <br /> (Rewsec 3/2013) <br /> ) <br />