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Feb. 22. 2016 1 : 27PM No. 2018 P. 2 <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 425-2578857 www.everettwa.org <br /> SITE ADD SS: , PROPERTY TAX# p HMIT# <br /> (1() <br /> () `�� Uv. P.:*,-,,r'An .0.;\-- uv\1 " -'� (kJ( 2 1 [L' i/.'iit)���►.( t) IV 1I�m2—O T) <br /> LEGAL for new construction: Short Plat/subdivision_ .Lot No. ,.. (attach copy of long legal description) <br /> OWNER t t.Yote'`t, .(yPhone/E-mail (..('L(S.... ''..7q;*°I ...." I'j.1: ..-ty <br /> Address (11.R !i'"` r (?).t'.f''..e.:V\ -_i) 1 ,t.'t....A. City/State/Zip '71;:v(J. e.1 /(,c.44 e:(-8'111,76 <br /> APPLICANT:_Owner _Owner's Agent Contractor _Contractor's Agent —Tenant(mixt provttica?otter atcommit limit the owlet 10(In Work IntttnVaal) <br /> CONTRACTOR ")(-k,. •�.((t-:~{-V\`2> State Lie,# V.A.i I.6q"V. 'i()V'V-.City Bus.Lic,ii 01?raoS1 <br /> Address .;/)\.&01'E t.:V'Q.:V.0A Al,A'.: Phone/mail 4.(,J-• .e -z,...,,lt-(.(.).;,)._,. <br /> • <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT <br /> r ti-std'`''. idt._e.(...L.1.-0'i-3°c:<. (1/t... <br /> Phone/E-mail f <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK r')Of�)n t)l) <br /> Existing Use Of BuildingHEAT SOURCE: <br /> Proposed Use of Building _, Gas Electric Other. ____ <br /> Building type: .,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 /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type of Project: _New_Addle ,Alteration_Repair Type of Project: _New_Addn _Altoratlon,._ Repair <br /> Show Number(fl)of fixtures Show Number(#)of fixtures <br /> NC–air handling units Toilet <br /> • <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 Water heater <br /> Exhaust fan _ Sink(service/bar/mop/etc.) <br /> I Heat pump Backflow preventer <br /> Unit heater Urinal <br /> Boiler Drinking Fountain <br /> Refrigeration Floor drain <br /> Woodstove Grease trap <br /> Ducting Roof drains _ <br /> Other —, Modical Gas <br /> SPRINKLER/ SUPPRESSION SYSTEM Other: <br /> Number of Heads Other; <br /> I hereby certify that I haw:read and examined this application and know rho::mite to he true and correct.All provisions of laws and ordin:rncee governing this type of work will he compl <br /> with whclhor npor:i6rd herein or not.The granting of a permit doe::nut pn:ranne to give authority to violate or cancel Iain[envision or any other state or local law rogulating cntt::bur:lion <br /> That 1 not auntor'eed y the owner of thin proparty to intik/in)the work tor which application in made and I comply with Ste:,tate Contractors Law 10,27 RCW and 290.200A WAC. <br /> Owner/ 'ulhorized Agent Signature ll Date (Revised 9/2014) <br /> # 0.51 <br /> L <br />