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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 /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> SITE ADDRESS: PROPERTY TAX# PERMIT* <br /> L t I) /" 3 1.�� ��t t� S T (.2 4./3120)&0004 181/V/g67'6d <br /> LEGAL for new construction: Short PlaUsubdivision Lot No. (attach copy of long legal description) <br /> OWNER ) doe it yvk - Z Phone/E-mail <br /> Address 7 f(? Ekotivq. City/State/Zip !Sue y'(, "" t �i, 9PO3 <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 1 G—wk fA✓ke— L& I Lic. # COE Bus. Lic.# <br /> 1, <br /> Address (64-01hkp>n'+�S � iF f'TTl X 51- Phone/Email 7c�- <br /> /- 7 7 7 a_ <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT <br /> PhoneiE-mail <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK <br /> Existing Use of Building C-r'A'{ -PS'G € N ,k HEAT SOURCE: <br /> Proposed Use of Building l TK.'r Ate. Gas Electric Other <br /> Building type: Single Family Duplex Townhouse Multi-Family Commercial <br /> Type of project: New Addition Remodel X Repair T.I.,T Sign Sprinkler Demolition Change of Use <br /> DESCRIPTION OF WORK(additional space provided on the back): <br /> oY` A 6fiA)I TiNAt- ILAS cia9v+tA,tc� <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 j 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 I 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'sad and examined this application and know the sante to be true and correct.All provisions of laws and ordinances governing this type of work will be complied <br /> with whether spec ifiedtherein or not.The granting of a permit does not presume to give authority to violate or cancel the provision of any other stale or local law regulating construction <br /> That I am ayttioriAd by4he 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 /> / 2 <br /> /1/ <br /> � . U ._. <br /> �/, io..,.7w1 RMMoI <br />