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411 • <br /> 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# PERMIT# <br /> 711 9/ 7 Pt 213-----r in W l eft?OO/ <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> OWNER k/5.5/fV/( 7/) 7 - /1- 17 Phone/E-mail <br /> Address 7// cjI51- pL � 1,716�4:1/371.4- City/State/Zip <br /> APPLICANT: Owner _Owner's Agent Contractor Contractors Agent Tenant(must provide a letter of consent from the owner to do work in the space) <br /> CONTRACTOR ,y ; (�fll State Lic.# City Bus. Lic.# <br /> �71( ��/w/' r, �'c 1/ L=%01 `�8206 22c— 547 > <br /> - <br /> Address Phone/Email ��.72i--'"-" <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT <br /> 0 To/1444y 206'-429- -o/0/ <br /> Phone/E-mail <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK 3S1 tl(p <br /> Existing Use of Building HEAT SOURCE: <br /> Proposed Use of Building Gas Electric Other <br /> Building type:Ingle 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): _ (`vr' 1i ova <br /> t -owx adds-7-1-on Z 5 1 add, <br /> bollem Roo/ walk in Glos 4 <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type of Project: _New_Adds _Alteration_Repair Type of Project: New_Addn _Alteration_Repair <br /> Show Number(#)of fixtures Show Number(#)of fixtures <br /> NC—air handling units Toilet <br /> Forced air systems Bathtub <br /> ( Gas piping Lavatory(wash basin) <br /> Water heater ! Shower <br /> Gas fireplace j Kitchen sink&disposal <br /> Gas range Dishwasher <br /> L Clothes dryer Clothes washer <br /> Range hood i Water heater <br /> Exhaust fan • Sink(service/bar/mop/etc.) <br /> Heat pump j Backflow preventer <br /> Unit heater Urinal <br /> Boiler j Drinking Fountain <br /> Refrigeration Floor drain • <br /> Woodstove Grease trap <br /> Ducting ! Roof drains <br /> Other j Medical Gas <br /> SPRINKLER/ SUPPRESSION SYSTEM Other: <br /> 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.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 /> / <br /> 12/O 5I� <br /> Owner/Authorized Agent Signature / Date (Revised 3/2013) <br />