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HERMIT APPLICATIC <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: tQ - -in. <br /> T S PROPERTY pz, DOJ0DUDO A11PERMI1U C <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> OWNER ---V6 , x7/11 6 /7)/ Phone/E-mail 572 572_3.—057, 9Z Z <br /> Address, 'zdie' tri(7 City/State/Zip&7976 %/79 9,24/ <br /> APPLICANT:,Owner _Owner's Agent _Contractor Contractor's Agent Tenant(must provide a letter of consent from the owner to do work in the space) <br /> CONTRACTOR g/V.,OG,9/, ' State Lic.# 'r)(_A< tct 1(7 1 Z City Bus. Lic.# <br /> Address Phone/Email <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT 4,NJ y A6--Z771/e— <br /> g74 / d' Phone/E-mail V2 2 93 56/,3 r6, <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK /6Oel. 472) <br /> Existing Use of Building Jr/-� HEAT SOURCE: <br /> Proposed Use of Building 5/�/e Gas X Electric Other <br /> Building type: _Single Family _Duplex_Townhouse _Multi-Family Commercial <br /> Type of project: New Addition ii Remodel Repair T.I. Sign Sprinkler Demolition Change of Use <br /> DESCRIPTION OF WORK(additional space provided on the back): <br /> rr'e, I \C's_ ,j11,,i,V1,/t( (L4- wr✓l't - <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type of Project: _New_Addn XAlteration 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 /> I 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(inside bldg) <br /> Unit heater Urinal <br /> Boiler Drinking Fountain <br /> Refrigeration Floor drain <br /> Woodstove Grease trap <br /> Ducting 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 autho t d by the o er 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 /> t Cj if Sl'`-S--- <br /> Owner/Authorized Agent Signature Date ( sed 4Revi /'1015) <br />