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�� <br /> D � <br /> �� D <br /> IERMIT APPLICATION JUL o B ZZ15 <br /> BUILDING/MECHANICAL/PLUMBING/SIGN/SPRINKLE ./ �1P1;cM&S <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: 1 PROPERTY� (33 TAX# P M(IT# <br /> 14 , 1507 —W3 <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> OWNERS CO + + Chrt�j 4 111QYJ-5 CL..L_C(C, Phone/E-mail.! 14'1S-,'f7q(495C, ellH (0, clot ;C �►1 <br /> Address L 13 0 '-A-h• L8 City/State/Zip hC5C A—",,v;t(I Q� coo cf—�G 7u <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 State Lic.# ; 6 j /_ 7 1i City Bus. Lic.# <br /> Address /I/ IS kj k)) (L(ce 6k ACj, On 3 I Phone/Email 56`1-914-r— b-7 <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT <br /> �. VnneC (-'knAzr� <br /> 1 t b f �� Phone/E-mail '�9 <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK <br /> Existing Use of Building x C> uy, ki, 4`�C �� HEAT SOURCE: <br /> T—` <br /> Proposed Use of Building yt- t , cLti >Vic Gas Electric Other <br /> Building type: _Single Family _Duplex_Townhouse _Multi-Family _Commercial <br /> Type ofproject: New Addition Remodel Repair T.1. Si —Sprinkler Demolition Chane of Use <br /> DESCRIPTION OF WORK(additional space provided on the back)' <br /> ;1"tr\'>>-�.�� ��• t� Ck-,c h r\�1 1 r -� 2�''i� <br /> 011-fir C�t�r-,�� I c� kl ���1 {r3 r{q P�t�� Vr ! 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 Lavato 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 cerfify 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 specked 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 perforin the work for which application is made and I comply with the State Contractors Law 18.27 RCW and 296.200A WAC. <br /> Owner/Adfhorized Agent Signature D (Revised 912014) <br /> �`Z <br />