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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: OPERTY TAX# PERMIT# <br /> t 3 2 f3 .�1 z�t`t eta, w� PRZ510!5 <br /> 51 d 5 1 g o o 14 v ct q o ca, — ®® <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> OWNER T QV 2005' L L.0 Phone/E-mail <br /> Address I (rcvFF"y City/State/Zip 07 4-)O <br /> APPLICANT: Owner Owner's Agent ,Al Contractor Contractor's Agent Tenant(must provide a letter of consent from the owner to do work in the space) <br /> CONTRACTOR CVn-t AIT SlG T-Y, State Li c.# —L,L,4-1 f ria 0 ity Bus. Li c.#V tj 8 <br /> L(32 J S ( � t 5'.0 L tlk-&t o,.- <br /> Address P, t1QAng p. TXCot4 - WA � hone/Email 253- E(75-SZSZ `�' <br /> TENANT BUSSIINESSYN�AME CONTACT FOR PERMIT <br /> T L 1 S t< r V S Phone/E-mail SCVJP A't V <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK �� � <br /> Existing Use of Building OErA/L, HEAT SOURCE: <br /> Proposed Use of Building v-ET ti�I L� Gas Electric Other <br /> Building type: _Single Family _Duplex_Townhouse _Multi-Family Commercial <br /> Type ofproject: New NZAddition Remodel Repair T.1. Sin Sprinkler Demolition Chane of Use <br /> DESCRIPTION OF WORK(additional space provided on the back): <br /> t I,� �`C(0 r-J o t,1 leo V-o �1 AGS <br /> e LL r -c o ., fa t, <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 <br /> 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 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 1827 RCW and 296.200A WAC. <br /> c1 to( 301 I <br /> dwne uthor' d Agent Signature Date (Revised 9/2014) <br /> V2- <br />