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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: PROPERTY TAX# PE MIT# <br /> �i 'Z Z �•�, . <br /> LEGAL for new construction: Short Plat/subdivision l;'JF• ?,,J.N.RLaT 6 JY,35Lot No. I yrZZ'(r3tfactfcopy�f fongle al de ription) <br /> OWNER 60 1<ag 2 tC-O-S SJE CLOSS one/E-mail Z Z( zoo <br /> Address �jp 'Z - City/State/Zip n <br /> APPLICANT: 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 /> CONTRACTOR Statte,Lic.#(C NC.--li 10 City Bus. Lic.# <br /> Address �C7 CC7`ZG,40 C �()�. �t/4 (f' `lG�'i�� Phone/Email <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT <br /> �Zl-e " `E_ we NS4-_ <br /> �jZ�j.► 5� � � NC. Phone/E-mail t <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK C> <br /> Existing Use of Building L\ HEAT SOURCE: <br /> Proposed Use of Building G' � GGc.v�-) Gas Y Electric Other_ <br /> Building type: _Single Family _Duplex_Townhouse _Multi-Family X Commercial <br /> Tvpe of ro'ect: New Addition Remodel Repair X T.I. Sin Sprinkler Demolition Chane of Use <br /> DESCRIPTION OF WORK(additional space provided on the back): <br /> Lor fST�Ucst�o ti d-iF=— ISe,J W e>01 L V1 t.1ty l x—)C-uVe� 14em1.o011— <br /> A-p2t T-ioof �571>f�a j2 E PFJ 04- Atp,A, FArl-to ,)A-s i+qtx- Ta Mit-Acc cssi r�5,L�i TY <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 <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 whet s ecified 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 a aut rized by the owner of t ' pr erty to perf work for which application is made and I comply with the Stale Contractors Law 18.27 RCW and 296.200A WAC. <br /> caner/Autho ed Agent Signa Date (Revised 9/2014) <br /> I /C;� <br />