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• <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:n-6E-ei•Vellekliy/ PROPERTY TAX# I PERM IT,LEGAL for new construction: Short Plat/subdivision / Lot No. (attach copy of long legal descriptiioln) <br /> OWNER%'M./444444/949 L,Wvcv 145*-7 Zd-c... Phone/E-mail <br /> h ' l97 <br /> Address a0id 164 . /~-VE I✓L , 6,4-4,100 City/State/Zip 13e��4G--(.�� / <br /> APPLICANT:_Owner _Owner's Agent 'i Contractor _Contractor's Agent _Tenant(must provide a letter of consent from the owner to do work in the space) <br /> CONTRACTOR 40110-(C__. (1/4" qL&I Lic.# Ek1T Z tec}UZ COE Bus.Lic.# <br /> TO Address T i3. sl-" &7k) C�� �/4i*Ji4 00/ Phone/Email ,104-.2-CT 89 L <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT/ a�.y 5-5---42492-4 <br /> 909. "' /l�,`{ <br /> /`�9. aks Phone/E-mail /'� ��� <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK 51/8,a <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._Sin Sprinkler Demolition_Change of Use <br /> DESCRIPTION OF WORK(additional space provided on tpp'e back): 4C' f 't 4 XV 0c."-r— am.r kst.opyt u,r ,enert7 <br /> 4-4.-6b4ocar^^'u 1yo AU- Mti <br /> Gcimx-U� C-r.-.to G-e.Jr f"t04c{,a , $/ . <br /> L 44400.A/ <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 /> 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/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 spedS 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 /> 64011 <br /> 1 <br /> r n uthorized Agent Signature Date (Revised 6/2012) <br />