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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 /> SITE ADDRESS: 6/Oel �E Je f� Meta PROPERTY TAX# PERM T# � <br /> `6 / / i .50 7 --U4—2 <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> OWNER Phone/E-mail <br /> Address City/State/Zip <br /> APPLICANT: x Owner _Owner's Agent _Contractor Contractors Agent _Tenant(must provide a letter of consent from the owner to do work in the space) <br /> CONTRACTOR V, jrc/ M>°C�1Clvr,c l State Lic.# City Bus. Lic.# 0'130g- <br /> Address Phone/Email <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT <br /> C du�'t hle ce;,,-)Vill Cowl 631 0.)y R .1-tc,.md /111•CjC ,,I5 <br /> Phone/E-mail 3tio-38a'—OS C jade--6,Cfucf b(c bret.ile j, t-s1 <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK .1-L14-5,006 <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 the back): <br /> 1 w s4-a.Ilct.fi bn of 'beet e25; 4,,e m - t , •T v,s-lcL I lct -,'ort 04 <br /> ne 91t-tvy11z)}nq -CS {-vices in a a-flCOOv'l, Tv,S" /l aT siv) ahoy :)pkit(3 <br /> ivy ' tt(` kCcte aCe4• <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 2_ I 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 J Sink(service/bar/mop/etc.) <br /> Heat pump J Backflow preventer <br /> Unit heater Urinal <br /> Boiler Drinking Fountain <br /> Refrigeration I I Floor drain <br /> Woodstove Grease trap <br /> Ducting Roof drains <br /> Other I Medical Gas <br /> SPRINKLER / SUPPRESSION SYSTEM I 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 /> 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 Sig--• - Date (Revised 9/2014) <br />