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PERMIT APPUCATI?N <br /> BUILDING/MECHANICAL/PLUMBING/SIGN/SPRINKLERIDEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 rCedar St., Everett, WA 98201 425-257-8810 FAX 425-257-8857 www.everettwa.org <br /> V <br /> SITE ADDRESS: PROPERTY TAX# PERMIT# <br /> AIL <br /> LEGAL for new construction: Short Plat/sub ivision Lot No. (attach copy of Ibng legal description) <br /> OWNER LA kt Phone/E-mail <br /> Address T Z Eve City/State/zip &,eVCe , jLo.4 ! &j &Y16 <br /> APPLICANT:—Owner _Owner's Agent _Contractor _Contractor's Agent _Tenant(must provide a letter of consent from the owner to op work In the space) <br /> CONTRACTOR V 6-,'PCI:-N rte- azi4nw- State Lie.# Wbe6 ss0Z2-0 t City Bus. Lie.# Oo-7115=j <br /> Address 2-1-2,0 pCtac- k- I V, V - vi-A cT9 2-0( Phone/Email 4 2- 2tj'Z C <br /> CONTACT FOR PERMIT <br /> v J4AJe <br /> Phone/E-mail <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK 3;5� <br /> Existing Use of Building -AftD HEAT SOURCE: <br /> ` <br /> Proposed Use of Building Ayk 141 <br /> Gas K. Electric Other <br /> Building type: _Single Family _Duplex—Townhouse _Multi-Family X Commercial <br /> Type of project: _New _Addition _Remodel 1L Repair—T.I._Sign_Sprinkler_Demolition_Change of Use <br /> DESCRIPTION OF WORK(additional space provided on the back): <br /> IV, U V LT RCAT-6�a- A-i-- r.140P <br /> A l� &A,i A-yl,,:,-fit i►V,110I 5 Y0 <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 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 /> 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 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 orized 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 /> -' It) -2-b --I <br /> a Authorize tSignature Date (Revised 412015) <br />