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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 TAX# p (T# <br /> et 7- S421I at 11 o2 . s E �- reLz,t-( tt 04... 004, <br /> LEGAL for new construction: Short PlatisubdivisionCASCA.CTG t?A2%4- Lot No (attach copy of long legal description) <br /> OWNER SZAr f L.. 1�AC;t,r IL.. --1/2.00,4 ia-S Phone/E-mail (42.(;) <br /> Address 1t-c. S w r,Z tvt`e-ii.-F M11..4A-- LA,vM•-•1 City/State/Zip Ei)EU-CM LW... ai- 2...!C:4 <br /> APPLICANT: Owner _Owner's Agent _Contractor _Contractor's Agent Tenant(must provide a letter of consent frcm the owner to do work in tits space) <br /> CONTRACTOR SV..A' -1,.t – ?AC G,r%L Rom es State Lic.#S cATTN-1Ctt~;S i3 is City Bus. Lic.#Lost'3 -Zl .to--. <br /> Address S A 01„.Q.Q. Phone/Email 541.1n0,7_ <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT c <br /> -TC.:k• Ni (2-0Nw J Ld-- <br /> Phone/E-mail (-47---;\ 3,.,, Cs 4`C L <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK <br /> Existing Use of Building HEAT SOURCE: <br /> Proposed Use of Building Gas ✓ Electric Other! <br /> Building type: ✓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 on the back): <br /> 24 % 8 1lA4v G.afL ) .3p C- ?S3 - ‘403 - O®'-'1 <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type of Project: ! New_Addn _Alteration Repair Type of Project: t 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 j Bathtub <br /> `} Gas piping 4 Lavatory(wash basin) <br /> V Water heater Shower <br /> 1 Gas fireplace 1 Kitchen sink&disposal <br /> 1 i Gas range 1 Dishwasher <br /> Clothes dryer 1 Clothes washer <br /> { Range hood 1 Water heater <br /> t 0 ; 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 (.41 Roof drains <br /> Other --- Medical Gas <br /> SPRINKLER 1 SUPPRESSION SYSTEM Other: <br /> t 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 MI be complied <br /> with whether specified herein or not The granting of a permit does not presume to give authority to vio!ate or cancel the provision of any ether state or Iccai law regulating construction <br /> That I an auth rzed by the owner of!his property to perform the work for winch application is made and I comply with the State Contractors Law 18 27 RCW and 296 200A WAC. <br /> Ow r/Authorized Agent ignature Date (Revised 3/2013) \12— <br /> i <br /> /013) <br />