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• • <br /> PERMIT APPLICATI nl <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 /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> SITE ADDRESS: .� �{ PROPERTY TAX# PER IT (1 ( Q <br /> 1345 10 S"i ,� r 1 AWA cr$2e1 bb 3 - — 1?7j•-e>tr oC3 (j1 v `'.� ( <br /> LEGAL for new construction: Short Plat/subdivision LotlNNJ 1�17(attach copy of long legal description) <br /> OWNER Pe0151 FIIJC-41 _02-5)_02-5344,-T Phone/E-mail p) 7 ` el 49c' <br /> Address 1V 1011-16-r. �i i�l • City/State/Zip E [, j • 9-gzoi <br /> APPLICANT: Owner Owner's Agent VContractor Contractor's Agent _Tenant(must provide a letter of consent from the owner to do work in the space) <br /> CONTRACTOR GaS1.JM M L&I Lic.*L*1-1)14p°44 1.�,N1— COE Bus. Lic.# <br /> �� <br /> Address 4 Or�/ 111,04 dlwA 4275 Phone/Email (42 ) et 31-ro t 6 3 <br /> TENANT BUSINESS NAME CONTACT FOR PERMITKviN Cflie16Hj+{N <br /> Phone/E-mail (4 2-5 -!/�31 -(/�`7�$f 3 <br /> BUILDING PERMIT APPLICATION`rCONTRACT PRICE OF WORK 27 <br /> Existing Use of Building h�D�F,cE ‹.I 1j6L& HEAT SOURCE: <br /> Proposed Use of Building R•eiIPe•p- Jta L SAM I W Gas ✓Electric Other <br /> Building type: _Single Family V.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): Ft6IR• 15 <br /> A1-t4/ IF/ L <br /> c'uF-r 5;114. <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 Z Toilet <br /> Forced air systems Bathtub <br /> Gas piping 2 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 /> I.� 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 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 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 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 /> g/ 1/DeO31a (Revised 6/2012) / <br /> iL <br />