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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: IIz�GS cF-AFTn"VkN PROPERTY TAX# I P RMIT# <br /> &U 1 T O,5- Z.190S7113DOZ08100 4' <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> OWNER j65j/ Phone/E-mail <br /> Address City/State/Zip <br /> APPLICANT: Owner 7yOwner's Agent _Contractor _Contractor's Agent _Tenant(must provide a letter of consent from the owner to do work in the space) <br /> CONTRACTOR L Q�J�j-� UC �� State Lic.# City Buss. Lic.# <br /> Address 5%- iff. AVE,57M& 7C�Z17 Phone/Email <br /> TENANT BUSINESS NAME fd�7T Orr f=Vf CONTACT FOR PER�M7IT�G1M�i f:G \IVA LKF-9- <br /> Phone/E-mail (06C,6 / 5 ,416rd, X04 <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK 1200,000 <br /> Existing Use of Building {� HEAT SOURCE: <br /> Proposed Use of Building J/ Gas X Electric_ Other_ <br /> Building type: _Single Family _Duplex_Townhouse _Multi-Family -X Commercial <br /> Type of project: New Addition Remodel _Repair T.I. Sin Sprinkler Demolition Chane of Use <br /> DESCRIPTION OF WORK(additional space provided on the back): TFN41JlT IMMOVf-/UlFV47,2r, <br /> *Lu Dl& /ftPzic;E� PAkrrnal www , noURS� v�iinlDa wsi 5usj' y lr f� Cru 7 <br /> ANO G A.rwol-�, <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 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:m�authonz e owner of th 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 /> /O <br /> Owner/Authorized Agent Signature Date (Revised 9/2014) <br />