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-R,, IT ,A PPL CAT[1© <br /> MIL©IING/MECHANICA /P LU I ,l ING/SIGN/SPRONKLER/DD EMOLOTION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 Cedar St., Everett,WA 98201 425-257-8810 FAX 425-257-8857 www.everettwa.org <br /> jSITEADDRESS: . PROPERTY TAX# I Mill0P01) bl ' <br /> R23— 5l5'r PI�ce ‘� <br /> LEGAL for new construction: ShortrtPlat/subdivision Lot No. (attach copy of long legal description) <br /> OWNER ('( t iroa CISNeL Phone/E-mail 4Zc1 37(f-360/4 �^ <br /> Address 602,2& — 5/5r 45 J g City/State/zip �(/ T(1 4/A. "7 c U/.3 F <br /> JAPPLiCANT:,_.Owner _Owner's Agentgei _Contractor Contractor's Agent _Tenant(must provide a letter of consent from the owner to do work In the space) <br /> 'CONTRACTOR GV aZeCLe ) (14/ii Y_ (*Ark k A & 'State Lie.# - J 02241r City Bus. Llc.#�a`1 S5 <br /> ?52-31 1,4 <br /> Address 2.1 Z1 eilekcZ.. Phone/Email i <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT <br /> Kcry 5gLo (ggzs-3 z62 3if-f <br /> Phone/E-mail 014aQ 2e7&jGC.CO11GY/ <br /> Eill IIL©IN0 PERMIT APPLICATION (CONTRACT PRICE OF WORK If //OM <br /> se of Buildin HEAT SOURCE: <br /> Existing U 9 , / <br /> Proposed Use of Building Gas__ Electric 1C Other . <br /> Building type: V 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): I�F�¢T SY STEIK <br /> REp1A-G. UECAJc P-104.4K. , WITH 1 --(4.) of <br /> MECHANICAL PERMIT APPLICATiJON PLUMBING PERMIT APPLIICATII*N <br /> Type of Project: New Addn Alteration_Repair Type of Project: New Addn Alteration Repair <br /> 1 <br /> Show Number(#)of fixtures Show Number(#)of fixtures <br /> NC—air handling units I Toilet <br /> i Forced air systems Bathtub <br /> • <br /> Gas piping I 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 /> Exhaust fan • Sink(service/bar/mop/etc.) <br /> _l Heat pump Backflow preventer <br /> Unit heater Urinal <br /> Boiler Drinking Fountain <br /> Refrigeration I Floor drain • . <br /> Woodstove Grease trap <br /> DuctingRoof 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 298.200A WAC. <br /> 11197(/-•/— 3"`�'� <br /> Owner/Autf orized Agent Sig$ a%e <br /> e <br /> Date (Revised 3/2013) <br /> elt,"11/•,-5- 0.y...." <br />