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0 0 <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:1140 2 5.6.-. Jiim pyi wit toy PROPERTY TAX# P ;MM #,__,J �Lt <br /> LEGAL for new construction:llShort Plat/subdivision Vf- IY• Lot No. (attach copy of long legal description) <br /> OWNER Er"'1 f1 r'144'L Phone/E-mail <br /> Address City/State/Zip <br /> APPLICANT:_Owner _Owner's Agent /Contractor _/ Contractor's Agent Tenant(must provide a letter of consent from the owner to do work in the space) <br /> CONTRACTOR ftf41EOAf� 5101/ COnP0'14►1€,J State Lic.# /0110 5CO31413 City Bus. Lic.#00,'_2).00(e. ' <br /> Address /255 v4'7(/JA( ,thy°(,. ,v c Kftr 9'S/D9 Phone/Email Sid—7"'-07149 <br /> TENANT BUSINESS NAME CONTACT FOR PERMITha( 0mod' <br /> 00� /v/ Phone/E-mail ,f/-✓Q Zr )Vvi1W u/1�5i'?/lo/ • (1i 1 <br /> TJ'G ffii�� �J'1 <br /> BUILDING PERMIli APPLICATION CONTRACT PRICE OF WORK # 6/ g.5-6 -se <br /> --- <br /> t <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. ign Sprinkler Demolition Change of Use <br /> DESCRIPTION OF WORK(additional space provided on the back): <br /> In/ t eel <br /> on 1( n(Cht s i ,Ct( Fg( (L LiA,‘,a ( 3O`sic"' (✓tFAlicr <br /> 9'1E1� w� SIGn� a c(XIf71N6' . <br /> 114,50 "U'r4 4 , IN1'p1u't (we') 4WD Rtiot$r f� ipi P4,✓i2f 09v 5 Q-rY, Pyi•/✓ Profs. <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 I 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 ha rea.'andxamined 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; ereilf, r n,#t.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 r th of riff 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 /> /- 20"r5 <br /> Owner/Authori •d Ag= Signature Date (Revised 9/2014) IL <br />