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• • <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 425-257-8857 uwvw.everettwa.org <br /> SITE ADDRESS: PROPS TY TAX# ERMlT# <br /> 1,161 N$S06 P - b��.hb . 2800)oo3035oo ',' C <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> OWNER 11/4)6e2(J06b . �(14.AN0 1.-LC. Phone/E-mail 42s g%l • Z I 1 3 <br /> Address --P.0.10X SS 13 • <br /> City/State/Zip tr E1 E VL)(, IA q 203 <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 iiiiikerScAlf ne/ 74,0#1. State Lic.# �N/I" ' / <br /> / - _ <br /> z <br /> 1/-- _� ' l y1C� City Bus. Lic.# Ci �(]�t� <br /> Address y/02. /3 /Z 1V4 Amh.eme,e, w1. dP8®0/ Phone/Email .Z.,* - €733 9- .719-0/ <br /> TENANT BUSINESS NAME II 11 CONTACT FOR PERMIT <br /> LA-7Pka1-t� F.n it.1S Chs 5,t yuh gee:W-1 7-707l� <br /> Phone/E-maiI6(>,.(.'/1 a may, cf Nq.G o44 A <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK $ 238,00D• °O <br /> Existing Use of Building q- i <br /> HEAT SOURCE: <br /> Proposed Use of Building U.(aiwt14ot,rbe Gas ✓ Electric Other <br /> Building type: Single Family Duplex Townhouse Multi-Family V Commercial <br /> Type of project: V New Addition Remodel Repair /T.I. Sign S rinkler Demolition Chan e of Use <br /> DESCRIPTION OF WORK(additional space provided on the back): tsk,(kk} ( }}�� /' <br /> _( n � � �� �-0��.11��E JNikiZ o t(II,C [{�IAG , <br /> .:>_ak(l(t\t�lA4L. ; . JNi - V30441003E. .7.-Las t-11((13, Elf.LP YA- (,,,,r, I(')1?EAt•'Orvl , 2)0Ni4-��YE <br /> j t.AV ✓6.)k t.SC. r:.(1.(2) i__ wt{5U1E QS t(SS?lAtocal.S iRo►JS i hj)CAwtt'I,it2(. 1�1 all 6,(21, W i(1)Cn1r;It.'?(L)Jii SFA4 <br /> v-((i �L' - 670 .ZNNs Ai\� i(. OR(L t C�" .i116S. Zi6Sk-Rlt NktvizAIII CP 1 i <br /> MECHANICAL PERMIT APPLICATION ' PLUMBING PERMIT r PLICATION <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 /> hA/C-air handlin units <br /> Toilet <br /> Forced air systems Bathtub <br /> 1'7 Gas piping o014,k Lavatory(wash basin) <br /> Water heater <br /> Shower <br /> Gas fireplace Kitchen sink&disposal <br /> Gas range Dishwasher <br /> Clothes dryer <br /> Clothes washer <br /> Range hood Water heater <br /> 1.3 Exhaust fan <br /> Sink(service/bar/mop/etc.) <br /> Heat pump <br /> ------ - --- <br /> Backflow preventer <br /> 2 Unit heater <br /> _ Urinal <br /> Boiler <br /> Drinking Fountain <br /> Refrigeration <br /> Floor drain <br /> Woodstove <br /> Grease trap <br /> Ducting <br /> Roof drains <br /> } Other S-p 9S�tM. <br /> ;\. SMedical Gas <br /> SPRINKLER / SUPPRESSION SYSTEM <br /> 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 comp' <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 au..' -.by the• ner 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 /> Ow r/A ,i'►!zed A. nt Signature b <br /> Date (Revised 9/2014) <br />