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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 /> Crt-f/t.- acf( <br /> SITE ADDRESS: PROPERTY TAX PE I # <br /> i06/n /h l&- 5E 4-ke,-a-1, 1 <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> OWNER AlF" 1..yr- Phone/E-mail S 17V5-/ze/Y-74,S6 <br /> Address /24.2-,j5R.)r, 5)76::/f4,2/e/ City/State/Zip A,ii/fik 1441. 462,..7, <br /> APPLICANT: x 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 / /k / a,M/— (eb i4#7 ) 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 a 0 I. I_ ,11,/ail <br /> Existing Use of Building HEAT SOURCE: <br /> Proposed Use of Building Gas_ Electric_ Other_ <br /> 1 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 /> eelkir T/ov1-Slit s 9- CGt► iws Vz-&I/ , -J. fi /u//66i <br /> faInc., ' Liu/ye/nee5 - 1t')n5 t- lat,��111401 �- a�f�)/ i6?5 <br /> iteliMECHANICAL 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 .6 )4 Toilet <br /> 6) X Forced air systems �� Bathtub <br /> Gas piping a Lavatory(wash basin) . <br /> ) ;I' Water heater Shower <br /> C) X Gas fireplace c )( Kitchen sink&disposal <br /> Gas range C x 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 /> () 2 Ducting Roof drains <br /> Other Medical Gas <br /> SPRINKLER/ SUPPRESSION SYSTEM I Other: <br /> I Number of Heads I Other: <br /> I hereby certify that I have read and examined this application and know the same to be true and correct.At provisions of laws 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 296.200A WAC. <br /> C2._ <br /> V-h/Owner/Authnri7P.ri Anent Sinnatura (Revised 3/2013) <br />