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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 /> SIT A DDRESS: KM� L 9A PROPERTY TAX# PE MI±q <br /> uY U-• .� l L) <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copyoflong legal description) <br /> OWNER �� �' Q Phone/E-mail6L2-6:-7-5--7-13- tvv= <br /> Address City/State/Zip <br /> APPLICANT:X-Owner _Owner's Agent _Contractor _Contractor's Agent _Tenant(must provide a letter of consent from the owner to do work in the space) <br /> CONTRACTORtkax- , St�a/te Lic.# City Bus. Lic.# <br /> Address �1 - — �`�`� t-t' Phone/Email <br /> TET BUSINESS NAME CONTACT FOR PERMIT <br /> pt6� <br /> Phone/E-mail � 5 ,6yfr('W � <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK �Tv <br /> Existing Use of BuildingJa` LrU,C' 4' _ HEAT SOURCE: <br /> Proposed Use of Building _ <br /> Gas Electric Other <br /> Building type: _Single Family _Duplex_Townhouse _Multi-Family Commercial <br /> Type of project: New Addition L Remodel . Repair_T.1._Sign_Sprinkler Demolition Change of Use <br /> DESCRIPTION O``F WORK(additional space provide on the bac <br /> �P�a9irr�v\ �� e� �. U1Ltzhx l� <br /> adAx,*L�OwL ^A04 <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 I Toilet <br /> Forced air systems Bathtub <br /> Gas piping Lavatory(wash basin) <br /> Water heater ! Shower <br /> i Gas fireplace Kitchen sink&disposal <br /> Gas range Dishwasher <br /> Clothes dryer i Clothes washer <br /> Range hood j 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 i Floor drain <br /> Woodstove Grease trap <br /> Ducting Roof drains <br /> Other Medical Gas <br /> SPRINKLER / SUPPRESSION SYSTEM I 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 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 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 /> /; cjajt� R-�,d <br /> Owner/At orized Agtttt76-nature Date (Revised 3/2013) 1 Q <br /> 1 <br />