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HERMIT APPLICATION <br /> BUILDING/M ECHANICAUPLUMBINGISIGNIS PRINKLERIDEMQ LITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 Cedar St., Everett, WA 98201 425-257-8810 FAX 425•-257-8857 www.evereftwa.org <br /> SITE ADDRESS: PROPERTYTAX# P IT#t <br /> ItG' v <br /> LEGAL for new co!._-fiction: Short Plat/subdivision Lot No. (attach copy of Ibng legal description) <br /> OWNER CFiu5'&y2-5 j Phone/E-mail Y75 86-0 <br /> Address 2zol Jkj 'f City/State/Zip E()12Wl W4 qb 20 <br /> APPLICANT:_Owner _Owner's Agent �t--Contractor —contractor's Agent _Tenant(must provide a letter of consent from the owner to dp work In the space) <br /> CONTRACTOR aca-tA, zr,4; `K— State Lic.# �Vb865 022-DY c * City sus. Lic.# 0071557 <br /> Address 2t-2-0 PACtrV— AUG. I; -A 89220( Phone/Email 42- -3i,l <br /> TE1qANT BUSINESS NAMECOT T OR PERMIT S.Lr�YY` <br /> �� � <br /> TfA���rt( r73� Phone/E-mail <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK TF006 <br /> Existing Use of Building ��q HEAT SOURCE: <br /> Proposed Use of Building <br /> G�� Gas� Electric Other <br /> Building type: „Single Family ___,Duplex Townhouse Multi-Family X Commercial <br /> Type of project: _New _Addition _Remodel Repair_T.I._Sign_Sprinkler_Demolitior_Change of Use <br /> DESCRIPTION OF WORK(additional space provided on the back): <br /> R L) -0 <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type of Project: _New_Addn _Alteration-k_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 l avafory(wash basin). <br /> MSPR� 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 preventeF(inside bldg) <br /> Unit heater I Urinal <br /> Boiler Drinking Fountain <br /> Refrigeration Floor drain <br /> Woodstove Grease trap <br /> JWKQER <br /> Ducting jRoof drainsMedical Gas <br /> /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 compiled <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 /> TThhat_I amauthorizedby 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 /> Own er/Auth orizelloAgent Signature Data (Revised 4/2015) <br />