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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: U�/ li&' r. PROPERTY TAX# PERMIT#C — (0, <br /> LEGAL for new construction: Short Plat/subdivisionLot No. (attach copy of long legal description)) <br /> OWNER e4�U,I Ge,�Y;.. 1 LLC Phone/E-mail/ <br /> Address City/State/Zip <br /> APPLICANT:_Owner _ 'Owner's Agent X Contractor _Contractor's Agent _Tenant(must provide a letter of consent from the owner to do work in the space) <br /> CONTRACTOR kp V1te,(' Y Al oni State Lic.# ?V&3 IS) City Bus. Lic.# <br /> 1 � 1 <br /> Address 0 A -?c% I I 'P ti tH t, 4A Phone/Email 6 •- 7 t,;L-4 3 S t <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT 20& - f 5cl - 55-L <br /> Phone/E-mail creep c' 12;v;,eels' -9�0v4I^ o.4 <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORW L Cl K <br /> Existing Use of Building HEAT SOURCE: <br /> Proposed Use of Building Gas_ Electric_ Other_ <br /> Building type: _Single Family _Duplex_Townhouse _Multi-Family X 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): r-1 u�om rj �,,tLCI(Af Jre ecf; t/ S Oil Ift V d <br /> UJ �cc. Veft,,tir • Sti>up 4-4 me,tnNtn n StcArwwIV. <br /> SC.;,Mill, <br /> /� � /► QU "`�.. <br /> ( -�rr p-dcS-kia A Frrte c- O y\) <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 /> j Water heater Shower <br /> R Gas fireplace Kitchen sink&disposal <br /> Gas range Dishwasher <br /> Clothes dryer j 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 i 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 7F Other: <br /> 1 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 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 stale or local law regulating construction <br /> That I am aut !zed 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 /> Owner/Authorized Agent Signature Date (Revised 3/2013) <br />