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#1 <br /> %RMIT APPLICATIO <br /> BUILDING/MECHANICAL/PLUMBING/SIGWSPRINKLER/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: �,f n� ��� S/. ,>;�G�e a PFKXTR YTAX# Nn#b <br /> `7 t... 4 Tl ... <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> OWNER %WVk4,--:Ycviftff- Phone/E-mail g2JV- Z,-1,0 %0 <br /> IV <br /> Address otIl W h L.rt.l bIA0 ✓ %O.Jl, J� ^ <br /> ,,r ity/State0p 604 t`Kk, 416 V S 3 <br /> APPLICANT: Owner _Owner's Agent —Contractor —Contractor's Agent —Tenant(must provide a loner of consent from the owner to do work in the space) <br /> CONTRACTOR 10 CO WO-� State Lic.# City Bus. Lic.# <br /> Address Phone/Ernail <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT <br /> Phone/E-mail <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK <br /> Existing Use of Building HEAT SOURCE: <br /> Proposed Use of Building Ga45—� ElectricX Other_ <br /> Building type: Single Family _Duplex Townhouse _Multi-Family _Commercial <br /> Type of project: New _Addition Remodel _Repair_T.I._Sign_S rinkler_Demolition_Chan a of Use <br /> DESCRIPTION OF WORK(additional pace provided on the back): <br /> �!G << ��`uJ y. f lta, '`I�'P tr:Kc2 .f u�r,{,�r" x.k. (�►'c-c.> l ce.. #etc. �. <br /> Nfft-,* pig- • <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type of Project: New Add, _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 /> 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/m etc. <br /> Heat pump Backflow preventer inside bid <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 /> Tha au rized by the ow rope to= <br /> o pert the work for which application is made and I comply with the State Contractors Law 18.27 RCW and 296.200A WAC. <br /> Owner/Authorized A ent Signature Date (Revised 4/2015) <br />