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r • • <br /> 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 /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> SITE ADDRESS:9W- 6C <br /> X47 PROPERTY TAX# I P f o sY <br /> 14 <br /> LEGAL for new construction: Short Plat/subdivision / Lot No. (attach copy of long legal description) � <br /> OWNER%'M.44444"`J �V 1,4i/GO Mg ri Z-4(... Phone/E-mail , ��jp <br /> Address x010 t st, - ,'4•VE )(+�� SU4 h-wo City/State/Zip i3G 4/ e.--1.� 9.V-- 7 <br /> APPLICANT:_Owner _Owner's Agent YContractor _Contractor's Agent Tenant(must provide a letter of consent from the owner to do work In the space) <br /> r <br /> CONTRACTOR t"to.- ? <br /> _ qL&I Lic.# T .te 'UZ COE Bus.Lic.# <br /> Address 3((( i3S S4- Vk) c444(_%>/4btii4 /e4"/ Phone/Email ,3o4-2-c 04L <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT <br /> 2 4492- <br /> l3rG S _ Phone/E-mail 4/4,6,' ;414c4fb Le t <br /> , co, <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK 51/ <br /> Existing Use of Building HEAT SOURCE: <br /> Proposed Use of Building Gas_ Electric_ 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 t�?e back): 7-J4.1146. /4G,C' 4" F.4t xi/ ov'— �A.,S /`'�wr <br /> DW ( <br /> 4-0,14...CC- (oc� • <br /> Z ro /}(4 M Gc,�'v4.1.(� 14i -,m cg /red.- /•4.•••#,(.4..10. S t <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 r-a• examined this a tion and know the same to be true and correct.All provisions of laws and ordinances governing this type of work will be complied <br /> with whether specifi-• or not.The gran' ,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-uth• . • e own- . this•Arty 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 /> 6 4011 <br /> • n- •uthorized Agent Signature Date (Revised 6/2012) <br />