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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: 1 . oc— � PPERTY TAX# PERMIT# <br /> uecip•} Iw0.y 8nst9ooC1U(y S15D <br /> Z- 00 if <br /> LEGAL for new construction: =Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> OWNER '�°S'�-T4- I"& O( Cc Phone/E-mail I <br /> Address (2.41I Vet sy tlVC) City/State/Zip 54uc i•v Ci1�y C4 91604 <br /> APPLICANT:_Owner _Owner's Agent x Contractor _Contractor's Agent _A Tenant(must provide a letter of consent from the owner to do work in the space) <br /> CONTRACTOR Me-/erASt v�4- tiS±1 State Lic.# Mey 1L cSA 03 �ity Bus.Lic.# <br /> Address�G70 fit.--( l9 .SotJ-4� �O�►�Y<-f�tc�y�� ci z P one/Email,7C)'l2i(1325 bNettleI/'2ss(lii• CC1L1'l <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT (% fl I `Ykc <br /> Rea Robm ?to-Y2k t1� <br /> Phone/E-mail ID,I(�(Ad-(-fir 914.C�o ul <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK 3Vj i <br /> Existing Use of Building R'e5- uta c""'t-t HEAT SOURCE: <br /> Proposed Use of Building 1t"e54Q st....� Gas_ Electric Other <br /> Building type: Single Family _Duplex_Townhouse _Multi-Family Commercial <br /> Type of roject: _New _Addition Remodel _Repair T.I.. Sign Sprinkler_Demolition_Change of Use <br /> DESCRIPTION OF WORK(additional space provided on the back): <br /> Replace 4 f t tc w Qat SOyst5 <br /> Zeict«. 2 e 51•`as De ceefea•AcdSets <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 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 applic ion is made and I comply with the State Contractors Law 18.27 RCW and 296.200A WAC. <br /> Owner/Authorized Age Signature Date (Revised 9/2014) rr <br />