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IERMIT APPLIC ATIOP <br /> BUILDING/MECHANICAUPLUMBING/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 /> /-� I� ILL" Z3r <br /> SITE ADDRESS: � EFiT <br /> PROPYTAX# PERMIT# <br /> LEGAL for new construction: Short Plat/subdivision Lot No/.. (attach copy of long legal description) <br /> OWNER PAUL AN17 Phone/E-mail paN� M It••[Q <br /> Address Lf � QQ <br /> t �7 AV w I; City/State/Zip C [��(� WA -l C <br /> APPLICANT:Owner V Owner's Agent TTCoontractor Contractor's Agent Tenant(must provide a letter of consent from the owner to do work in the space) <br /> CONTRACTOR �RI7�DV�£ �•((1�,'7d�L`(Z�J State Lic.# ���a?AI/ �D(7& C A City Bus. Liic..# � 'l <br /> Address I rJ ©C)O V IL �G� (jgEf_0 g-i,Mk�. u Cf'�-�� Phone/Email �L/ <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT JP�MI C=1 <br /> 7W7_1 t qT++ AVE <br /> Phone/E-mail ,,E-61. WA, 2)11 5 FI (a CQ 't: <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK l� © ©t� <br /> Existing Use of Building GJ,1�C'It.G"r�'`1�—� ���7( Nl�i HEAT SOURCE: <br /> Proposed Use of Building ND C6 Gas Electric Other <br /> Building type: Y Single Family Duplex_Townhouse Multi-Family Commercial <br /> Type ofproject: New Addition _%,oe Remodel Repair T.I. Sign—Sprinkler Demolition Chane of Use <br /> DESCRIPTION OF WORK(additional space provided on the back) <br /> 4�-� lG-�,�t�ln1C�l/ 1 ca►�( , I NCL-Ut7� C-) P-.1�Ct`�1�� c' = <br /> ®tom W t I•lt�t� �Sn oN� cz <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 Lavatory wash basin) <br /> Water heater Shower <br /> Gas fireplace Kitchen sink&disposal <br /> Gas range l 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 /> Refricleration 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 comp <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 authorized 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 /> 5/2-(/�:o "E�;_ 1Z <br />