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Ill • <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: 'PROPERTY TAX# I PERMIT# +�� <br /> Rr;30 1� v Y L h� 'tt,- <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> OWNER g yQ a 4 1, fev, Phone/E-mail 4 zr 3 9 —97/8 <br /> Address 7/nn Cl/cc/leer 1.247City/State/Zip (tAo, if1 /wA c29 i >2 <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 S Pc per,, ��S L&I Lic.#/S�r_Q c 943--.11) COE Bus.Lic.# <br /> Address /9/O uUY/ ACO�►A. Irk,a,,».� LAN Qv 07 Phone/Email &jr-J77_ua 9L <br /> TENANT BUSINES NAME/ l ONTACT FOR PERMIT 4�./-273_0071 <br /> C o4 5-L4KM-f -WC Phone/E-mail JNo, % (a SP.eY��-.s*�p/%> - rot" <br /> BUILD G PERMIT APPLICATION CONTRACT PRICE OF WORKI _,$ 7r/aD2 a' <br /> Existing Use of Building HEAT SOURCE: <br /> Proposed Use of Building GasElectric Other <br /> Building type: Single Family _Duplex Townhouse _Multi-Family _Commercial <br /> Type of project: —New Addition Remodel ®Repair T.I._XSign Sprinkler Demolition®Change of Use <br /> DESCRIPTION OF WORK(additional space provided on the back): <br /> staif 6\Gw0e1 Lei-leys G;„ wad( <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 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 wit be complied <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 /> I7—/� it/A <br /> 0wn ed Agent Signature Date (Revised 6/2012) <br />