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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 425257-8810 FAX 425-257-8857 www-everettwa.org <br /> SITE ADDRESS: PROPERTY TAX 4 PERMIT'# _ <br /> �r fJ 577 <br /> LEGAL for new construction: Short Platlsobdlvlsion _Lot No. (attach copy of long legal description) <br /> OWNER Phone/E-mail <br /> Address v — City/StatelZip <br /> APPLICANT:­Xbwner _Owner's Agcnt XCcntractoF Contractor's Agent Tenarit(mustwovi Ra <br /> rRt6r p(con:cnt from the owner to da work in the space) <br /> CONTRACTOR t,� �,� state Lig.# F3 0 <br /> a cit ass. Lic. na <br /> Address Q, 4 '� Q B }�g Phone/Email •Ot 8 ab <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT JaA►'Yll L k-y\,o-A M1 <br /> Phone/E-mail Y�r�t tC7 Lp <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK <br /> Existing Use of Building HEAT SOURCE: <br /> Proposed Use of Building Gas Elcctnc V Other <br /> Building type:/r.)-Single Family _Duplex_Townhouse Multi-Family _Commercial <br /> Type ofproject: Now Addition Remodel Repair Y�-T.1. Sin Sprinkler Demolition Chane of Use <br /> DESCRIPTION OF WORK(additional space provided on the back/- <br /> ZYFTLS G�nC-� C��C�� �7��L✓�!� <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type of Projsct: _New 4Addn _Alteration_Repair Type of Project _New Addn XAlteration._Y Repair <br /> show Number(#)of flxfures Shaw Number i of furfures <br /> A/C,air handling units Toilet <br /> Forced airs stems Bathtub <br /> Gas pipin Lavatory wa&h basin <br /> Water heater Shower <br /> Gas fireplace Kitchen sink&disposal <br /> Gas range Dishwasher <br /> Clothes dryer Clothes washer <br /> Ran e hood Water heater Lae - <br /> Exhaust fan Sink service/barlmo /etc, <br /> Heat Pump Backflow Ereventer <br /> Unit heater Urinal <br /> Boiler Drinkino Fountain <br /> RefrigerationRefrigeratiori Floor drain <br /> Woodstove Grease trap <br /> Ductino Roof drains <br /> Other Medical Gas <br /> SPRINKLER / SUPPRESSION SYSTEM Other- <br /> Number of Heads Other; <br /> I hereby certify that I have road and examined this application and know the same to be true erld correct.All provisions of laws and ordinances 9overning this type of vrort;will be camp <br /> h whetherspecitlec herein or not.The granting of a permit does not preawne to glue authortty to violate or cancel the provision of any other state or local lbw regtlsting construction <br /> Tho I em authorized by the own r of this property to perform the work fo whit appli�on is made and I comply with the State Contractors Law 1821 RCW and 29E,2oo/A WAG. <br /> narlA�ktiori�ed Agent Signature Date (F?evlSt3d 9.�09Qj <br />