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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 rax a PERM Co - D 01 <br /> 2.1 s s�+�{ ba•• �J .Vzt G r <br /> LEGAL for new construction: Short PlaUsubdivisiorCSC.A O` ?A214— Lot No34 (attach copy of tong legal description) <br /> OWNER a..A tt t.....2.. �acc i-t(...... k.--i-ovvt IGS Phone/E-mail CA 2s- C-t 3 - 2 i,C_VGs <br /> Address ttC s v„ tit d cGLv.:tc 0`- gto...... LAAAr...t City/State/Zip E) Lair 1,...4.4".• . c liQsit;4 <br /> APPLICANT: Owner _Owner's Agent _Contractor _Contractor's Agent Tenant(must provide a lege,of consent trcm the owner to dc wont n the space) <br /> CONTRACTOR.ii-.At'"Z'f,,.1L l l-cC.a.r-q I-VjAAes State Lic.#ScA'CTQtiGC;s{3 L., City Bus. Lic.#j,c3 -Zc..j0--- <br /> AL <br /> Address 'j/*yKCa. Phone/Email s,t1,,M7_,_ <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT I-Ct-k-Ni CZA LAP"—,L <br /> PhoneiE-mad 642—S\ 4Q <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK <br /> Existing Use of Building HEAT SOURCE: <br /> Proposed Use of Building Gas ✓ Etectnc Other_ <br /> Building type: t"/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 cn the back): <br /> e.15 i O^ _ 0014 oI <br /> 2...Q.-1 .(=. ' t-,'' .'"--) CZE ) cap.c - — t <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type of Project: ''New_Addn Alteration_Repair Type of Project: 4ew Addn _Alteration-__Repair <br /> Show Number(#)of fixtures Show Number(#)of fixtures <br /> -- A/C-air handling units - Toilet <br /> k I Forced air systems i i Bathtub <br /> 4 i Gas piping 4 Lavatory(wash basin) <br /> V Water heater t Shower <br /> I Gas fireplace 1 Kitchen sink&disposal <br /> i Gas range Dishwasher <br /> 1 Clothes dryer 1 Clothes washer <br /> t Range hood a of <br /> I.D f Exhaust fan I Sink(service/bar/mop/etc) <br /> Heat pump — Backflow preventer <br /> Unit heater <br /> -- Urinal <br /> Boiler —. Drinking Fountain <br /> Refrigeration . Floor drain <br /> -- Woodstove — Grease trap <br /> -- Ducting (./ Roof drains <br /> Other .- 1 Medical Gas <br /> SPRINKLER / SUPPRESSION SYSTEM Other: <br /> I 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 writ be complied <br /> with whether specified herein or not.The granting of a permit does not presume to give authority to vro!ate or cancel the provision of any ether state or local law regulating construction <br /> That I arty auth tied 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 ROW and 296 200A WAC. <br /> J.) <br /> 1 <br /> Ow/ r/Authorized Agent ignature Dots <br /> (Revisei,3/2013) <br /> I <br />