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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 1,/uR5 se evere 1- U�1 u 14- I�J PROPERTY TAX# ���/�S ;i PE�MIT�o / r®® <br /> io— <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) Si e,444c. <br /> OWNER C el(9;4 Nit it I LLL ��" Phone/E-mail <br /> Address Vuti° kC(t (JK-) ,`V42 ,>1C City/State/Zip '-LYV <br /> APPLICANT: 14 Owner Owner's Agent J4 Contractor Contractor's Agent _Tenant(must provide a letter of consent from the owner to do work in the space) <br /> CONTRACTOR t'Gf>r 0 `` State Lic.# City Bus. Lic.# 0`440 <br /> �d7 5 c�fh 5cf ls�C1 ` /© . ecu 1� T .Curt <br /> Address Phone/Email i <br /> TENANT BUSINESS NAME CONTACT FOR PER IT + <br /> r tom✓ Nu yM3�-- <br /> Phone/E-mail c� c�u� Kai V�TI�� l ✓ (ot/� <br /> , <br /> f <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORKI 7 Zo <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. Sin Sprinkler Demolition Chane of Use <br /> DESCRIPTION PF WORK(additional space provided on the back): <br /> it(va�lr�c4cl 66AnNI GW,1r- 5e+ (eu&n iL)cvz�D and c.,mc(i �'r kr�j <br /> � J <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 p mp Backflow preventer <br /> Unit heater Urinal <br /> Boiler Drinking Fountain <br /> Refrigeration Floor drain <br /> Woodstove Grease trap <br /> Ductin 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 /> Thal1 a 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 /> W001 qlm�� 2 5 <br /> Owner/Authorized Agent Signature Date (Revised 9/2014)12— <br />