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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 R ��' ,/� t <br /> 11030 :r t\ SE-- 2�3o519O03fl1eOO I O4 <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> �fy 2yy <br /> OWNER IC JNv r('4 ?AreTNG2at <br /> 5 Phone/E-mail 425 c�83. <br /> Address 234 E I711;•1ST #I103 City/State/Zip 'TA N p (A CiZ(l- <br /> APPLICANT:_Owner _Owner's Agent _Contractor Contractor's Agentr_Tenant(must provide a letter of consent from the owner to do work in the space) <br /> 1 <br /> CONTRACTOR riN 1 X R ' N ATIOState Lic.#ritsa ((LXSSl,71A/ City Bus.Lic.# <br /> ,501'2_ <br /> Address X4.3-?i W &sT/AN BASTE j-g WwciNV ILLS Phone/Email ZO6,4(„s 1W1 <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT <br /> v V DODg2.0.jlc A pTg SF—s 253 633 S..5 Scl�•uE T <br /> Phone/E-mail �-��ilNtt�2> <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK $ 30/OrYD <br /> Existing Use of Building APA12-Tiatc.N7S HEAT SOURCE:' <br /> Proposed Use of Building <br /> 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): REPC IVX-p DAM p CrEI N TERZ 1=-1O1IN IS H 6 Si <br /> SID1N<r SOFFIT IN UNITS 10g,ZO 1�3og. pplia. N kRC.E TRUSS TAtI. <br /> DAMpAe. @ Dt.,17 3oe, <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 <br /> Unit heater Urinal <br /> Boiler Drinking Fountain <br /> Refrigeration Floor drain <br /> Woodstove Grease trap <br /> Ducting I Roof drains <br /> Other 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 authorized by the owner of this pro.-• o perform the work for which application is made and I comply with the State Contractors Law 18.27 RCW and 296.200A WAC. <br /> thrf, <br /> , t(2— <br /> Owner/Aut•• ed •tent Signature Date (Revised 9/2014) <br />