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ErRMIT APPLICATIO <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: 09 3,4 y AVE E t PROPERTY TAX# PERMIT#C10 •_C <br /> 2-9- <br /> LEGAL for new construction: Short Plat/subdivision 60:7` 1 1017 tYO Lot No. (attach copy of long legal description) `I <br /> OWNERO& 6 POnNA "6l `114 v--GikiPhoonne/ a 60 teg 1-75. izVt6-61QN6- Aj ‘�/�/ 11 <br /> Address I e 411 61— City/State/Zip '01L1 <br /> `? <br /> APPLICANT:_Owner Owner's Agent X Contractor _Contractor's Agent _Tenant(must provide a letter of consent from the owner to do work in the space) <br /> CONTRACTOR—ri\ Ci V N-f g. State Lic.#i I` `L City Bus. Lic.#Of Z ( R <br /> Address ,34I5 a-i4 &- m.0A) 0; ti /A,1 I WAPhone/Email p_ �'� <br /> TENANT BUSINESS NAME CONTACT FOR��PppEpRMIT 1®t .S �y -�J ( -i cj <br /> Phone/E-mail ._. / yA71 c � _ <br /> BUILDING PERMIT APPLICATION � CONTRACT PRICE OF WORK '74)001 10- '?)5J0-0-0Existing Use of Building ioFAIN y LC t (4,--1- 1() <br /> 14--�1005''0" HEAT SOURCE: <br /> -Proposed Use of Building ,4' ,Ig L G 114111t LU1 C *lGvVT-- ' Gas_ Electric L Other <br /> Building type: Single Family _Duplex_Townhouse _Multi-Family _Commercial <br /> Type of project: New Addition 'K Remodel Repair T.I._Sign_Sprinkler Demolition Change of Use <br /> DESCRIPTION OF WORK(additional space provided on the back)y 0LJ c3 64 444 Pi4/v'r IA /(ao-u ,) <br /> 14 ltrv� i�r�Cf,��- . .1• 2 af4*ev - S� w,n�r S� z,S <br /> 6 017-- ) V4P,A1 eAtC► iu1 E f 1Piza-f' i42,8e12- 5c Lc-v (... Lxj/4- Lvr, <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 /> I Forced air systems ! Bathtub <br /> !K Gas piping Lavatory(wash basin) <br /> I Water heater Shower <br /> i j Gas fireplace Kitchen sink&disposal <br /> l ! Gas range I Dishwasher <br /> Clothes dryer j Clothes washer <br /> Range hood j Water heater <br /> Exhaust fan Sink(service/bar/mop/etc.) <br /> Heat pump Backflow preventer <br /> Unit heater I Urinal <br /> Boiler j Drinking Fountain <br /> Refrigeration ( Floor drain • <br /> Woodstove I Grease trap <br /> Ducting I Roof drains <br /> N C Other j355,C , 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 togive 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 /> 7' 44(4 I-2-6 <br /> 1Owner/ orized g t Signature Date (Revised 3/2013) <br /> 12, <br />