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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 /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> SITE ADDRESS:Io � �� �v�RE _ -(t PROPERTY TAX# 3� PER j IT <br /> LEGAL for new construction: Short PlatJsubdivision Lot No. (attach copy of long legal description) <br /> OWNER E ALS (*Ya CC Z LVQ LLC- Phone/E-mail )a <br /> Add ress'bto ,�L C& W� _ 0Z City/State/Zip W Zo <br /> APPLICANT: Owner Owner's Agent _Contractor _Contractor's Agent _Tenant(must pr"o'�vvide a letter of consent from the owner to do work m the space) <br /> CONTRACTOR L&I Lic.#w� l% "X v s LA COE Bus. Lic.# <br /> Address 3Zoz S"j NG r V"Z WA (p©`jd0-z PhonelEmail - I-9 40 <br /> TENANT BUSINESS NAME CONTACT FJ&74IT <br /> 4z A is Phone/E-mail p%irQ L Gjila(LY W\ <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK S6 <br /> Existing Use of Building HEAT SOURCE: <br /> Proposed Use of Building Gas_ Electric Other <br /> Building type: _Single Family _Duplex_Townhouse _Multi-Family _Commercial <br /> Type of project: New Addition Remodel Repair_T.1._Sign_Sprinkler—Demolition—Change of Use <br /> DESCRIPTION OF WORK(additional space prov ed on the back): <br /> Rol &u-m mc-,< StvveR &Dvau.%.seer A/C,(1Z,B&W WXT4 N,-w <br /> I2,M WW D" amss ' A/C-, <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 I 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 I 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 auth riz d 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 1 <br /> % _ <br /> dw­n e r/ AeA Agent Signature Date (Revised 6/2012) <br />