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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:S 12- <br /> n 1 `Oy-� A ,L* vu 11Q n O� PROPERTY TAX# P MIT# <br /> LEGAL for new construction: Short Plat/subdivision O G I-ot No. (attach copy of long legal description) <br /> OWNER Q„U1 Phone/E-mail 2S ) 210 — 0Dy 2— <br /> Address <br /> Address '6\ L 'tel p + lkv ty-t V ) City/State/Zip C f(L-t W/A 19 O L 1 <br /> APPLICANT: Owner Owner's Agent 1)6 Contractor Contractor's Agent Tenant(must provide a letter of consent From the owner to do work In the space) <br /> CONTRACTOR1� S CA CQM( lr" S/t�atee Liic.#W E STEs*0 1-� City Bus. Lic.# L,5Ii I Ems <br /> Address A 0til -x.00-k StQ `lt Y tjT� 1022b Phone/Email gL06 �I (p — C) S <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT <br /> KocheE_WGSteCrlSola."iC . <br /> ,ty a G <br /> Phone/EE--mail (- lUoylN(v-0$scl <br /> BUILDING PERMITAPPLICATIONCONTRACT PRICE OF WORK 4 2, (0(a 0 - 00 <br /> Existing Use of Building J�1�. HEAT SOURCE: <br /> Proposed Use of Building (OEJt qc ? SoY0.y- j?�( Gas Electric_ Other_ <br /> Building type: X Single Family _Duplex_Townhouse Multi-Family _Commercial <br /> Type of project: New 4Addition Remodel Repair T.1. Sin_Sprinkler Demolition Chane of Use <br /> DESCRIPTION OF WORK(additional space provided on the back): <br /> Vest aJtA ?S! S Y Sfie.1-n <br /> 0-1) M 2 so RE <br /> ( I) P\/1 S-Z OO L- I`t��L SI-T i <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 for which application is made and I comply with the State Contractors Law 18.27 RCW and 296.200A WAC. <br /> IV,, ok � /I's <br /> Ow r/Aut orized Agent Signature Date (Revised 4/2015) <br />