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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 /> SITE ADDRESS: PROPERTY TAX q PERMIT#�� ©� <br /> 3t c 44 � PL. sem. tz�+ -tT tij O <br /> 61 <br /> LEGAL for new construction: Short Piat/subdivisiorCSCA OZ. ?A2tL Lot No.60 (attach copy of long legal description) <br /> OWNER „A,r`'[L,Sy ?AG..i-tL. -ovvt t`..S Phone/E-mail (4Z's-,cis-3 2.2c,'o <br /> Address Mp s aJerf.uri MAL i-tioAr,t City/State/Zip EJ€gra 1 Ll . 012 4 <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 SU.P.►'Tt t. NrC-AS-tc, 140y0 es State Lic.#5EATTPtic 3 L' City Bus. Lic.#("C3•-Z-(40,0 is <br /> Address SlIklAskra. Phone/Email SgtM r� <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT Sdk4-na CIA t z_ci <br /> Phone/E-mail (4v \ 3'5-43 4.Q0 2— <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK <br /> Existing Use of Building HEAT SOURCE: <br /> Proposed Use of Building Gas ✓ Electric Other <br /> 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 /> 1(76-I4C- `?-k..o.....) 2 CA C c ?NS Lc_ * R'3- t40442' - ©ot <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type of Project: 6/'''New_Addn _Alteration_Repair Type of Project: .4ew_Addn _Alteration_Repair <br /> Show Number(#)of fixtures Show Number W)of fixtures <br /> NC-air handling units '3 Toilet <br /> tr Forced air systems 2. Bathtub <br /> 4 Gas piping 4 Lavatory(wash basin) <br /> to Water heater I Shower <br /> L Gas fireplace 1 Kitchen sink&disposal <br /> l Gas range 1 Dishwasher <br /> L Clothes dryer L Clothes washer <br /> 1 Range hood 1 Water heater . <br /> LO Exhaust fan 1 Sink(service/bar/mop/etc.) <br /> Heat pump �- Backflow preventer <br /> _ <br /> Unit heater Urinal <br /> ,..- Boiler Drinking Fountain <br /> Refrigeration -- Floor drain <br /> — Woodstove -- Grease trap • <br /> Ducting LI Roof drains <br /> Other — Medical Gas <br /> SPRINKLER/SUPPRESSION SYSTEM t I Other: <br /> Number of Heads j 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 au ed by the owner of this property to perform the work for which application is made and I comply With the State Contractors Law 19.27 RCW and 298.200A WAC. <br /> `�Z <br /> L4//Owr/Authorized Agentature Date (Revised 3/2013) <br />