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ERMIT APPLICATICm <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: ga, 1P(o>, \ 'Z PROPERTY TAX# PER IT4 - O`I p <br /> LEGAL for new construction:``--Short Plat/subdivision Lot No.(Lfz ) <br /> (attach copy of long legal description) <br /> OWNER [Vh < �H'r(% Phone/E-mail ( 550g ( j]0Address A �� City/State/Zip lel _ Lai\ - ( b <br /> �ItJ� ) <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 ev(52_60[ ' L) S(y'r t✓ H(—]Al kj, State Lic.#EVE.( 55© .Di---- City Bus. Lic.#Ft?7R5j <br /> Address 0.12® �CPhone/Email(L 1 SJ t--7 -cri(1., <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT <br /> Phone/E-mail (tzS) 2-3(4f- <br /> BUILDING <br /> >t(y- <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK 56:0, <br /> Existing Use of Building HEAT SOURCE: <br /> Proposed Use of Building Gas_ Electric V Other <br /> Building type: X 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 /> ( c�._.(a-\ Our"( u- AA-SLtec ki f�N t cam, T Q. t•-cc -C. <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 Clothes washer <br /> Range hood i Water heater <br /> Exhaust fan r Sink(service/bar/mop/etc.) <br /> 1 <br /> Heat pump Du-Ctie� l'Catr• ,v p Backflow preventer <br /> Unit heater Urinal <br /> Boiler Drinking Fountain <br /> Refrigeration Floor drain • <br /> Woodstove Grease trap <br /> f Ducting Roof drains <br /> Other j Medical Gas <br /> SPRINKLER / SUPPRESSION SYSTEM j 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 th owner of this propert perform the work for which application is made and I comply with the State Contractors Law 18.27 RCW and 296.200A WAC. <br /> 4/4 '(C" <br /> Owner/Authori edAentsign re Date (Revised 3/2013) <br />