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rERMIT 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 ADDRESS: PROPER TAX# col_O21 _OD PE�3¢A f J D J -v�J <br /> /202 �r k s -1J �*t 2-g 4u- Id <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of!Ong legal description) <br /> OWNER VutNI IL.cD i N C._. Phone/E-mail 41,Cj^343--R OSS <br /> Address /1.0 1...., sal . IA ArNt City/State/Zip .PJ t-cr II`A, <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 /> wn <br /> CONTRACTOR (2- i }4 ito.se, State Lic. # HAe .4,143(Gq t)gj City Bus. Lic. # <br /> Address Phone/Email <br /> TERANTBUSTMESTRAVE CONTACT FOR PERMIT <br /> A-L. -r-Ft-1l..0 CZ. <br /> Ftx tJ 'k_p t t.. C.. Phone/E-mail . 10- a t A Ur V C-1 N A-P1-4 <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WOR &lobo a A-Hod•Co WI <br /> Existing Use of Building r-'1 4r, . HEAT SOURCE: <br /> Proposed Use of Building 5.A-M'_ Gas X Electric Other <br /> Building type: Single Family Duplex_Townhouse Multi-Family )(Commercial <br /> Type of project: New Addition ,(, Remodel Repair )(T.I. Sign Sprinkler Demolition Change of Use N b <br /> DESCRIPTION OF WORK(additional space provided on the back): <br /> pfs7D 29_,1 Q&I-'e.. ©wTW---05 k NODI NOC-1 C2) Rt-SC-V-06 Nn S <br /> tk Lo c.4.1..1(A.G Pcf2-U46c <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 ! 2. Toilet <br /> Forced air systems i Bathtub <br /> I Gas piping 12 Lavatory (wash basin) <br /> — <br /> � 1 Water heater ! Shower <br /> I Gas fireplace ( Kitchen sink&disposal <br /> I Gas range Dishwasher <br /> Clothes dryer Clothes washer <br /> I. Range hood Water heater <br /> Exhaust fan Sink(service/bar/mop/etc.) <br /> Heat pump Backflow preventer(inside bldg) <br /> I Unit heater Urinal <br /> I Boiler j Drinking Fountain <br /> Refrigeration Floor drain <br /> Woodstove Grease trap <br /> i Ducting Roof drains <br /> I Other Medical Gas <br /> SPRINKLER / SUPPRESSION SYSTEM Other: <br /> INumber 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 s•-cite. erein or n 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 aut' ,ri ed.y the ow r f 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 /> 51 215 <br /> Owner/•i, .ri Agent Signature Date (Revised 4/2015) <br />