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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# IT#W PoR oc,,J do o IA[PE <br /> -- 01 <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> OWNER 4L-)WeLCP <br /> ne/E-mail /AFef �)2` pt ieAddress 50. YAC �1V +e /State/Zip G+0 idles ( y o Yq <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 CI'Nr F��di�o and Ccidiii State Lic.# l FM H C p(,g6.q/CA City Bus. Lic. #6y55,3 <br /> Address T C• g 3,2C514,1_1(loatyl, y4, q,bo,60 I Phone/Email 01-12ci Pfem q-1111,10 WA <br /> TENANT BUSINESS NAME CONTACT FOR <br /> PERMIT _Te�eMy <br /> o�1 er <br /> vz,,- 6211- 12g3c1u:i1n 1[L -iw, Q, t4we' 5 Phone/E-mail i <br /> C 9. C oAA <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK <br /> Existing Use of Building ApA&Iviii ayhoiA Lo it lf) HEAT SOURCE: <br /> Proposed Use of Building r`�I Gas Electric /� Other <br /> Building type: _Single Family _Duplex_Townhouse X Multi-Family _Commercial <br /> T e of ro ect: New Addition ' Remodel Repair T.1. Sin Sprinkler Demolition Change of Use <br /> DESCRIPTION OF WORK(additional space provided on the back):� ��rf �'�� 5y5+em {k o►jQ I C��t f�{SS <br /> IST c (`J ��►1 htet{ ypmPS i Rl1l� r f�1fu I�iti L,,RII +'( A V,"n� ( ;,iv � ACM` <br /> 1- fl'^` 1 &M; y <br /> a�tfkr��} cafn►'��►�� b���d�� 1 <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type of Project: _New_Addn 4AIteration_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 <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 pennit 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 onzed 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 /> ca- it, t <br /> 0 erlAut rize Agent Signature Date (Revised 9/2014) /v <br />