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4IPP <br /> ERMIT APPLICATIA <br /> BUILDING/MECHANICAL/PLUIVMBING/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# PERMIT# <br /> CP50 ;,=..y a- C,>e f> 167-0 2it-r '15 r <{O3 X I 1X 006 <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> • <br /> OWNER,0‘,,.h. 0.o ll c— Phone/E-mail <br /> Address 6131 47 wG�— 4i ,1( ice,1) City/State/Zip <br /> APPLICANT: Owner Owner's Agent _Contractor _Contractor's Agent _Tenant(must provide a letter of consent from the owner to dp work In the space)spL <br /> CONTRACTOR f= f C. State Lic.# DP(J pa7ACr� City Bus. Lic +�s b7�tG� <br /> Address c Phone/Email s 10l �� <br /> Z 1� i�.1 �, l`7'`� :3r1 . Sl�cy�zl.,,,� `�►�� �.�a-��.ey.,,.v��. f`1 �w��o <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT <br /> --A,.,rbih. a ll it x(42$) Aa - 465 <br /> G P�'G+' Phone/E-mail <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORKCP� <br /> 350D 14p6tAq � <br /> t, <br /> Existing Use of BuildingHEAT SOURCE: <br /> • <br /> —e,..,....„0 <br /> Proposed Use of Building 1 t 5�116c��— as Electric Other <br /> Building type: Single Family _Duplex Townhouse _Multi-Family _i 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): t 0,1 4.. 6.) I�• r„� �,c �,c. �4 <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type of Project: _New_Addn I 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 /> i Water heater I Shower <br /> Gas fireplace 2 Kitchen sink&disposal <br /> Gas range Dishwasher <br /> 7_ I Clothes dryer 3 Clothes washer <br /> Range hoodWater heater <br /> • ( <br /> Exhaust fan 7 ' I Sink(service/bar/mop/etc.) <br /> Heat pump Backflow preventer(inside bldg) <br /> Unit heater Urinal <br /> Boiler r Drinking Fountain <br /> Refrigeration Floor drain <br /> Woodstove Grease trap <br /> Ducting Roof drains <br /> Other Medical Gas <br /> SPRINKLER /SUPPRESSION SYSTEM / Other:jc, „J,,'; <br /> Number of Heads Other: <br /> I hereby certify that I have read and exa u•'•-• ' application and know the same to be true and correct.All provisions of laws and ordinances governing this type of work will be complied <br /> with whether specified herein• •.The granti !.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 ow er of this prop./y 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/A .• ' -d 7�gent Signature Date (Revised 4/2015) <br />