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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 425-257-8810 FAX 425-257-8857 www.everettwa.org <br /> SITE ADDRESS: . PROPERTY TAX# PE IT# <br /> 36 y VC15 <br /> LEGAL for new construction: Short Plattsubdivision Lot No. (attach copy of long legal description) <br /> OWNER �(�/G' Phone/E-mail yz5 259 -2-1z-3 <br /> 2.1 z-jpp <br /> Address (j 9 �� 5 City/State/Zip CV�-t.f W4, -!O2U <br /> APPLICANT:—Owner _Owner's Agent ?S Contractor —Contractor's Agent _Tenant(must provide a letter of consent from the owner 4domr-k in me space)CONTRACTOR l e,3o,, T, c l�a `� art StateLic.# A/V49Ce I`& /-� City Bus. Lic. S <br /> Address y f 0 J /��,� v. Phone/Email 3 5 -7C7CC:J <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT v,�,'Af <br /> Phone/E-mail 360 (pS-/ •-7900 /tn�t/ Su�'Tt ILctL �Sp4S.Gar1 <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORKS Cn� <br /> Existing Use of Building HEAT SOURCE: <br /> Proposed Use of Building Gas Electric Other <br /> Building type: )C Single Family _Duplex_Townhouse _Multi-Family _Commercial <br /> Type ofproject: New Addition Remodel Repair T.I. Sin____:Sprinkler Demolition Chane of Use <br /> DESCRIPTION OF WORK(additional space provided on the back): <br /> DU C•V 1 e� �A zr^� �V A,\� <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 <br /> 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 coned.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 au rized 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 298.200A WAC. <br /> 17 S <br /> Owner/Authorized Agent Signature I Date (Revised 4/1015) <br />