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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 www.everettwa.org <br /> FROPERTYTAX# <br /> eal X393 7 O7 <br /> SITE ADDRESS:E E. <br /> se ck Cf. j✓efeif qq o3 PE) / D 1�D � <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legaldescription) <br /> j erfLe: -,n -50/-5. 7 jeK4i; .,e <br /> OWNER 2 G Phone/E-mail �j2s - <br /> Address sue E.. (O jJ n St,41 City/State/Zip 1 vcrelf) I/V H 203 <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 01/0 nets State Lic.# City Bus. Lic.# <br /> Address Phone/Email <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT <br /> Phone/E-mail �r <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK eG7 /®000 <br /> Existing Use of Building 51 Ie ,,1 , 1 HEAT SOURCE: <br /> Proposed Use of Building ;06 le F-014) I, Gas_ Electric Other/ Pellet <br /> Building type: x.Single Family _Duplex_Townhouse _Multi-Family _Commercial <br /> Type of project: —New _Addition _Remodel Repair_T.I._Sign_Sprinkler_DemolitionXChange of Use <br /> DESC IPTION OF WORK(additional space provided on the back): <br /> 6) via t I fia Ma Ke exi fiiii5 Mat I in-Floor 6401 e a rect. mit, a bra <br /> haelr41Sc >r�u 444Y--124-76 <br /> �YV1D�°G Gt �d �I y1� �%Z� IPS l l �-fm.. fieaw►17 <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 /> - <br /> - Water heater Shower <br /> Gas fireplace Kitchen sink&disposal <br /> Gas range Dishwasher <br /> Clothes dryer 1 Clothes washer <br /> Range hood Water heater <br /> I Exhaust fan Sink(service/bar/mop/etc.) <br /> Heat pump Backflow preventer(inside bldg) <br /> Unit heater E Urinal <br /> Boiler Drinking Fountain <br /> I ' Refrigeration Floor drain <br /> Woodstove € Grease trap <br /> Ducting Roof drains <br /> Other Medical Gas <br /> SPRINKLER / SUPPRESSION SYSTEM I Other: <br /> INumber of Heads I 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 1 t.The•rantin c • 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 b •-own 1 of this.o•p'.•perform the work for which application is made and I comply with the State Contractors Law 18.27 RCW and 296.200A WAC. <br /> Ownut he. ge S •na ure Date • (Revised 4/2015) <br />