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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 i <br /> SITE ADDRESS: TAX# P RMIT# <br /> 9 93v 4'vt r-yrctn W € y- Iso !PROPERTY <br /> I 15 O-Ook <br /> LEGAL for new construction: Short Plat/subdivision Lot No..// (attach copy of long legal description) <br /> OWNER PaA r i SEC a 0.v i 6 P'r.c.p r+i C� LL e" Phone/E-mail 4g 5" J6 3 8195 <br /> . <br /> Address 0.177 a.4 c-t:)o v t J City/State/Zip e <br /> V "s+ IY A f e.2 o <br /> APPLICANT:_Owner _Owner's Agent Xl Contractor _Contractors Agent _Tenant(must provide a letter of consent from the owner to do work in the space) <br /> CONTRACTOR G i-o dei r o a L .6 I (y State Lic.#ey055 5 44 Sq/M 1 City Bus.Lic.# <br /> Address 8' 0'T 1(o S-Fh 5+ SA 5 n o hom 1'*M Phone/Email 4 2 5- 4 SI - 9 4 11 <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT ) �"T'fl C rn <br /> Pet -o ba... 0,o[t e 5 e- j e¢ @ Gtro r-o a e l g n . can'? <br /> Phone/E-mail 4�S-�a O- 400 <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK -47-1-444421 as .o9 <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. VSign Sprinkler_Demolition_Change of Use <br /> DESCRIPTION OF WORK(additional space provided on the back): <br /> Ino4-0-14 one c-ha,nne1 I-flet- 6 13 at,ca c( rrtct1 1oi1"A (r tfeer <br /> rt b t 1 et;X-I' 'i or. <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 /> 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 a •r orized b e o r 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 /> - -� to ff115 <br /> Owner/Author'%d Al n—re Date (Revised 4/2015) <br />