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PERMIT APPLICATION <br /> BUIL®INGNECHANICAUPLUMBING/SIGN/SPRINKLERMEMO T10N <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 Cedar St., Everett, WA 98201 425-257-8810 FAX 425-257-8857 wvvw.evereftwa.org <br /> SITE ADDRESS: PROPERTY TAX# PERMIT# — <br /> GtY6a9511) w <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of Ibng legal description) <br /> OWNER i4VL)t)JA1 p 0;,ylAT Phone/E-mail <br /> Address —Zo o LV A City/State/Zip <br /> APPLICANT:—owner _Owner's Agent —Contractor _Contractor's Agent _Tenant(must provide a letter of consani from the owner to dp work In the space) <br /> CONTRACTOR EIf F 6'0-CIZN ''JJWi6 -5&-aI4bP`k(- State Lie.# F-\)F- I `55022-D • City Sus. Lie.# 0.-7e& <br /> Address 212tV V -I 2t� �j,t r(�2-0( Phone/Email 4 Z�) Z 'Z i, <br /> CONTACT FOR PERMIT <br /> /14P1r1* C61 J9, <br /> °�25-ZS2-3//`f <br /> Phone/E-mail <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK zL651 <br /> Existing Use of Building IN c- ��. C" HEAT SOURCE: <br /> Proposed Use of Building Gas Electric Other <br /> Building type: Single Family _Duplex_Townhouse _Multi-Family ,k Commercial <br /> Type of project: _New _Addition —Remodel Repair_T.I.—Sign_Sprinkler_Demolition_Change of Use <br /> DESCRIPTION OF WORK(additional space provided on the back): <br /> ��.R U� �- (.1.�� UN i+ tk(s� - ��rvl.e G.oc�"rc/►�, y�3,t,�Ca��� <br /> L)&W �z <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 J Toilet <br /> Forced air systems 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(inside bldg) <br /> Unit heater Urinal <br /> Boiler Drinking Fountain <br /> Refrigeration Floor drain <br /> Woodstove Grease trap <br /> I Ducting J Roof drains <br /> Other Medical Gas <br /> SPRINKLER / SUPPRESSIOM 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 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 /> Thateamorized 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 296.2DoA WAC.17,Owrre�rht4uthorz Agent Signature Date (Revised 41201 <br /> IZ <br />