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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 /> SITE ADDRESS: PROPERTY TAX# PERMIT# <br /> 69/6 SeRksA/ize 11 <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> OWNER Z/2..,4 `j0A/Z1/Q.S Phone/E-mail <br /> Address q/G 7j,ckc1/fid yj(t, City/State/Zip <br /> APPLICANT:_Owner _Owner's Aggent '.Contractor _Contractor's Agent _Tenant(must provide a letter of consent from the owner to do work in the space) <br /> CONTRACTOR1 . fc�L2i CD N( > State Lic.# 5-"Tin./4c/072.4-5 City Bus. Lic.# 43.5-40(NAddress I yZ �"T cC p�C/ $ L T Mop 1 I/ /c Phone/Email a/ZS— 3-30 ICI L16/, <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT <br /> Jed F 5 ,,21" A/25— 336 /994 <br /> Phone/E-mail /tA 14.1/"Ct l° e..."-7 1 NyCt./!od COM <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK /ZArObr OV <br /> Existing Use of Building SF HEAT SOURCE: <br /> Proposed Use of Building I a /Re.M,o,Ai S-cR Gas Electric_ Other <br /> Building type: 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 /> Av PC-e- /o 'J bL itk•Af CAW€.f'4z.c/ A pb/Lt/Da.) O'f / G/r'4')/y5rGvc v .041 4-- /NTG�!//Ott, <br /> /S '/3 Ate oel - 4- Palo IO.GC� 1jA 4.0 LL fo i74AkeTo <br /> . f� un..i&71 S <br /> /O' T�z L(.)/✓aLL/4, SOV,,/ <br /> :het,Jed/nl r7.!�<.t/ �,1,c /S (/f✓/I t'G f£C) t/ V'n��a�h, 5710.2,49,e_ (=.- <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 /> L A/C-air handling units Toilet <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 /> Heat pump Backflow preventer <br /> Unit heater Urinal <br /> Boiler J Drinking Fountain <br /> Refrigeration ( Floor drain <br /> Woodstove I Grease trap <br /> 1 Ducting Roof drains <br /> Other Medical Gas <br /> SPRINKLER / SUPPRESSION SYSTEM 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 grantin•'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 authorized by the owner of this prop- to perform the work for which application is made and I comply with the State Contractors Law 18.27 ROW and 296.200A WAC. <br /> ..wA( 1/" 3 L/ - <br /> Ow T ;. t Sig - re Date (Revised 9/2014) <br />