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'PERMIT APPLICATIOlf <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# PERMIT# <br /> C D �� — v� �✓ Q Z J 3 U'JtUJ v'✓ <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> OWNER PC`'IICI'►'ttt��,`� p,�l,,'y� ;! li�. Phone/E-mail (� <br /> Address 4i�14 <br /> 0 1 V l}� }`- v SL, kjs v City/State/Zip 1,� qXj d <br /> APPLICANT:—Owner _Owner's Agent _Contractor V/Contractors Agent _Tenant(must provide a fetter of consent from the owner to do work in the space) <br /> CONTRACTOR-7~V YLGIcl/h 1 /State Lic.# e\IFIl G-fZL-`1S"�{/2� City Bus. Lic.# C)�`faSv <br /> Address (i ( 50V T N�H�� S'�• S�,t W °[5��� Phone/Email -1/63 <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT/�_L,'., <br /> f–vn ko Phone/E-mail <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK 7 5w ,v <br /> Existing Use of Building HEAT SOURCE: <br /> Proposed Use of Building Gas_ Electric_ Other_ <br /> Building type: _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 /> r <br /> i-�,a i z) ,►,-I�he cI'ftA- kuAerS, &'-, d dvc,'4-u-rr,L, <br /> MECHANICAL PER'/MIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type of Project: _New_Addn Y 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 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 /> 2 Other Fans 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 /> UD/SVIS <br /> Owner/Authorized Agent Signature Date (Revised 4/2015) <br /> 11� <br />