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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' PROPERTY TAX# 1 F� 0� <br /> .S5 3o "Ev ec ace-etc 2Ssot-1t icoI Uc< o <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> OWNER WR 1v uVuti1) NA V S) Phone/E-mail <br /> Address p0 60% 355 91 City/State/Zip TtA.5t t, 0Y- 11-1 5 <br /> APPLICANT:_Owner _Owner's Agent _Contractor X Contractor's Agent _Tenant(must provide a letter of consent from the owner to do work in the space) <br /> CONTRACTOR U t,f Si ,\r\ 4- av t? -h ,Ai State Lic.# = (,2'E City Bus.Lic.# 2�0 <br /> Address 2110$ �� S "KZ�( 3 <br /> l"w letket.fece;i Y1,l tiro <br /> TENANT BUSINESS NAME ONTACT FOR PERMIT <br /> Nas,t Phone/E-mail S-k{=it(`tLprt�,°rsigv), <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK . 51000.00 <br /> Existing Use of Building CO`jWCt \( u AC. HEAT SOURCE: <br /> Proposed Use of Building 5 am.e/ Gas Electric_ Other <br /> Building type: _Single Family _Duplex_Townhouse _Multi-Family Commercial <br /> Type of project: ,New Addition _Remodel Repair_T.I. le Sign Sprinkler Demolition Change off Use <br /> DESCRIPTION OF WORK(additional space provided on the back): � �9 01, ,r PX(s��1/ \ns t-Gi.I ttal <br /> 'Auk) I\\,u ysi\aa-ec�� C otr\A t.1 4-cf u30‘ r C 161,1 <br /> 1S 3L .0 Ce 112 . 6)65i-ihf . <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(inside bldg) <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 /> INumber 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 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 /> 41 ' Z\ki <br /> D <br /> J 5 <br /> Owner/Authorized •ent Signature ate (Revised 4/2015) <br /> ``2- <br />