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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# I i n�udc4ar PERMIT151 ' DD� <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> OWNER Dar c ) Phone/E-mail 42-r— ?6 t 7o 98 <br /> Address 1-3s-?,0 Circ 40., (A) City/State/Zip �r f k?J--f- ., A4 992.7k- <br /> APPLICANT: <br /> 9 7k-APPLICANT:_Owner Owner's Agent y Contractor Contractor's Agent —Tenant(must provide a letter of consent from the owner to do work hi the space) <br /> CONTRACTOR Sfeto 4y .4fsrlS State Lic.# piptp S 44z- T City Bus.Lic.# <br /> Address l94it A. Joni p„ _ 98� o7 ' Phone/Email/4r.7j+ -W12– <br /> TENANT BUSINESS NAM— �� CONTACT FOR PERMIT <br /> DZaNIS 7e1'61ry Q RQY(oay ,+y Phone/E-mail jetio,,yoS' SftA ®VJV^ fr' <br /> S• C i <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK <br /> )---� 3 <br /> Existing Use of Building HEAT SOURCE: <br /> Proposed Use of Building GasElectric 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 /> �mS�fa I � ee Fox S or W611 <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 /> NC-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 Drinking Fountain <br /> Refrigeration Floor drain <br /> Woodstove Grease trap <br /> 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 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 authorized by the owner 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 /> Owne re 9--f Date (Revised 9/2014) <br /> \ I � <br />