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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 /> /o — a7�11 <br /> SITE ADDRESS: PROPERTY TAX# PERMIT# . <br /> 13akEvA ELAevz - -' et 75' -c ' cr-)w 83550 1c(c 1 GW 14I D -00 <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> OWNER C11V\S G jet(' t ►-, Orcr5 i/e7d ✓ Phone/E-mail 11 -5-- g9co A/2-57-23d1 6/W <br /> Address P71--( 15-7Th./91,-eSE City/State/Zip ,kiChyvt6\1 C(.8"-.2--C((� <br /> APPLICANT: XOwner _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 V V V j1 C/t State Lic.# City <br /> //Bus. <br /> u Lic.# <br /> Address 7U 1`{ 1574" 4vE S E ,JC S -c i#o1-' 154} LJ 4'6Z16 Phone/Email 4-/Z5 Z3 1 b f 7 8j <br /> TENANT BUSINESSIN/ NAME CONTACT FOR PERMIT 2 2 / �t�3 <br /> V , Phone/E-mail 47_5- S9 (o/'/8 <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK -300O. 00 <br /> Existing Use of Building - ER_ HEAT SOURCE: <br /> Proposed Use of Building S �12. Gas Electric Other <br /> Building type: X Single Family _Duplex_Townhouse Multi-Family _Commercial <br /> Type of project: New Addition Remodel X Repair_T.I._Sign Sprinkler Demolition Change of Use <br /> DESCRIPTION OF WORK(additional space provided on the back): <br /> ReKOOa1 01\ baceA&e\± apt, wir‘czoLus , <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type of Project: _New_Addn Alteration_Repair Type of Project: _New_Adds _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 I Lavatory(wash basin) <br /> Water heater Shower <br /> Gas fireplace I Kitchen sink&disposal <br /> Gas range I Dishwasher <br /> Clothes dryer I Clothes washer <br /> Range hood I Water heater <br /> Exhaust fan • Sink(service/bar/mop/etc.) <br /> Heat pump I Backflow preventer <br /> Unit heater I Urinal <br /> Boiler Drinking Fountain <br /> Refrigeration I Floor drain <br /> j Woodstove Grease trap <br /> Ducting I 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 h ' r71di. he granting of a permi not presume to give authority to violate or cancel the provision of any other state or local law regulating construction <br /> That I am a zed by the owner of this property to _ the wo for which application is made and I comply with the State Contractors Law 18.27 RCW and 296.200A WAC. <br /> \I2 <br /> Owner/Authorized Agent Signature Date (Revised 3/2013) <br />