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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:, Ort c �6', x��T 28-S /PROPERTY Z7�3o'{�j--� P RMIT# J f, i <br /> LEGAL for new construction: Short Plat/subdivision �� � � � Lot No. (attach copy of long legal description; U <br /> OWNER 6f2e---d IT�ee 0,o2,o o& LLC Phone/E-mail n <br /> Address Ia y qVedl-tk, 4 Y3 L t) City/State/Zip S7't-t T>1'� C;� CQ �I/G c� <br /> APPLICANT: Owner Y�-Owner's Agent _Contractor _Contractor's Agent _Tenant(must provide a letter of consentfrom the owner to do work in the space) <br /> CONTRACTOR /-1 ZAJ State Lic.# fpl eUJ ZN City Bus. Lic.# 04 35 <br /> Address v S u Phone/Email Ao TT 10q- <br /> 2-TENANT BUSINESS NAME CONTACT FOR PERMIT <br /> Phone/E-mail rtJAC<,1P_w <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK �g�i Cori <br /> Existing Use of Building UACA)✓T c f.,A—e✓L Y12STauYjvS)� HEAT SOURCE: <br /> Proposed Use of Building L-6 Gas Electric Other <br /> Building type: _Single Family _Duplex_Townhouse _Multi-Family `Commercial <br /> Type of project: New Addition XRemodel Repair T.1. Sin Sprinkler Demolition Chane of Use <br /> DESCRIPTION OF WORK(additional space provided on the back):MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type of Project: New_Addn Alteration_Repair Type Project: _New_Addn Alteration_Repair <br /> Show Number # of fixtures Show Number # of fixtures <br /> A/C–air handling units Toilet <br /> Forced airs stems Bathtub <br /> Gas piping Lavatory wash basin <br /> Water heater Shower <br /> Gas fireplace Kitchen sink&di osal <br /> Gas range hwasher <br /> Clothes dryer Clo es wa er <br /> Range hood Water ter <br /> Exhaust fan l Sink a e/bar/mo /etc. <br /> Heat pump B44flow pre nter <br /> Unit heater rinaI <br /> Boiler Drinkin Fountain <br /> Refrigeration Floor drain <br /> Woodstove Grease trap <br /> Ducting Roof drains <br /> I 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 comps <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 /> Owner/Authorized Agent SigrYatbre Date (Revised 9/2014) <br /> 1/ <br />