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0 • <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# 'TI/V PERMIT# <br /> 000 H / r TT' AVS -a l 2s go 3 �6cc-0 2-0s u <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> OWNER FVE ( gLjC– 16S Phone/E-mail y.23—"3ZZ ^ 1L:95 <br /> Address x606 jff6V41TT 4VE Sv/TE .700 City/State/Zip EUERErf- d� <br /> APPLICANT: Owner X 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 IState Lic.# City Bus. Lic.# <br /> Address Phone/Email <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT AJA Ry, CLAR K <br /> XF/NrrY AR644 AT eSV6RE -/T- mclarK9 XrINfrV 4R4A/AeVG--RC-Ir. COM <br /> Phone/E-mail <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK ryP�Ci/G''LGi• .y <br /> Existing Use of Building 5PbR'f5 AR AMA HEAT SOURCE: <br /> Proposed Use of Building 6P6 wrs /12,ENA Gas Electric Other <br /> Building type: _Single Family _Duplex_Townhouse —Multi-Family _Commercial <br /> Type of project: New Addition Remodel Repair T.1. Sin Sprinkler Demolition Chane of Use <br /> DESCRIPTION OF WORK(additional space provided on the back): <br /> JNCi2i�A-56 TIfE SIZE OF TIfe S'PiC—C— L)SED FOR 7^H`E SGoRE R�17 CO.uTR6c <br /> W-57-6M TD ACCPmoDA-TE CO/VTROCS FOR /q NEW SLv,2Er3dAa217, <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 airs stems 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 am authorized by the owner of this property to perform the work forwhich application is made and I comply with the Slate Contractors Law 18.27 RCW and 296.200A WAC. <br /> 2n�g4 (Z:t, ' 6 -12 -zoos <br /> Owner/Authorized Agent Signature Date (Revised 4/2015) <br />