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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 II Up!).#f <br /> h%/, /h yA 1L1r-- 5 iyel4, if/4 / tt —M <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> OWNER )/14 p t Phone/E-mail 4/ 5 >z4' -745G <br /> Address �nZt«57 , �y�G 5 ,2J j — City/State/Zip f/f U,51i/ MIA 9$'.7f} <br /> APPLICANT: XOwner Owner's Agent Contractor Contractor's Agent Tenant(Juustprovideataker ofconsent from the owner todowoikInthe space) <br /> CONTRACTOR O/4 ./ • ,NN-(r- @beGl?() State Lic.# City Bus.Lic.# <br /> Address Phone/Email <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT <br /> Phone/E-mail <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 /> T i i G- ,11,p!le 1//11A,P//i <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 /> X I Gas fireplace Kitchen sink&disposal <br /> Gas rangeX 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 /> • <br /> Ducting Roof drains <br /> • <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 taws and ordinances governing this type of work will 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 am authorized by the owner of this roperty to perform the work for which application Is made and I comply with the State Contractors Law 18.27 RCW and 298.200A WAC. <br /> V)/y <br /> (Revised 2/20131 <br /> Owner/Authnrl7ari Anent Sinnahrra <br />