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A <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(25-25.711857,,,a,www.everettwa.org <br /> SITE ADDRESS: PROPERTY TAX# PERMIT�#,� <br /> to7 1.711`�E�� NR-di <br /> V 1 1.AO4dt <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> • <br /> OWNER S; r Se C-4 S'.7- C&,n Com-Phone/E-mail` 41/5—2.5 •r► 6-ecc_ zt.3 <br /> Address � 4 S 4 �a City/State/Zip (�•..-f,_A/Z- - ").4"' <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 NM bk,1 i S�n C wS�J w(11c,".tv\c State Lic.#J,� (Q-LLd.L * UG4t City Bus. Lic.# 037 44-,ji, <br /> Address �`b tgo/( ftc 1' , -e-.,c. cat) Phone/Email LS 344 S 3 t'7 - ECT-D..+-ltt f . <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT .L <br /> S — C�4-1s t 1 �.M C-414-er Phone/E-mail 7..c— 3 N L 5 2 t <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK 175-0,77 -11 4 b5' (4(7 <br /> Existing Use of Building C 1+.tit c/ti. HEAT SOURCE: <br /> Proposed Use of Building C.h r'c-4. Gas .t Electric Other_ <br /> Building type: _Single Family _Duplex_Townhouse Multi-Family &Commercial <br /> Type of project: New Addition x Remodel Repair T.I. Sign Sprinkler Demolition Change of Use <br /> DESCRIPTION OF WORK(additional space provided on the back): ka<I( t-J elm <br /> • <br /> QK,�y4`n9 S 4,-e .44 /Ca.2tq 4 e��`Jci�O�t- <br /> 1 ✓ x . <br /> •R,.�'t fir, r <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 /> ( <br /> NC—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 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 Drinking Fountain <br /> Refrigeration Floor drain • <br /> Woodstove Grease trap <br /> Ducting Roof drains <br /> Other Medical Gas • <br /> SPRINKLER / SUPPRESSION SYSTEM I Other: • 41 <br /> Number of Heads Other: <br /> I nereby 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 294200A WAC. r <br /> t~ ,LCZ i <br /> (.-/ w.417th. <br /> h. ized Agent Signature Date (Revised 3/2013) <br />