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0 0 <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: 'S 2 3 �d PROPERTY TAX# PERMIT# <br /> 3 2 s+- SC a E. �53 1 1 _ j <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> OWNER Phone/E-mail <br /> Address City/State/Zip <br /> APPLICANT:_Owner Owner's Agent A <br /> Contractor _Contractor's Agent _Tenant(must provide a letter of consent from the owner to do work in the space) <br /> CONTRACTOR 13 F2 17- S►G� S EQ'4 I CE AState Lic.# �Jlaj rJ�J� � 0 PQ City Bus. Lic.#G. .�r'N.l� ( � <br /> Address I(�,�,2 r3o e�(-C�?(e}} � �I(��Xe cart 9W)2- Phone/Email 42,5.2,30.,MC) ��7fSf V)�✓nsr•Cc <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT <br /> y � <br /> Phone/E-mail 1742 5 . 33 0. 2�1 co 0 <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK 1� 3y 90 <br /> Existing Use of Building (20IAV-)ry1 PxUtA HEAT SOURCE: <br /> Proposed Use of Building N/h Gas_ Electric_ Other_ <br /> Building type: _Single Family _Duplex_Townhouse _Multi-Family X Commercial <br /> Type of project: New Addition Remodel Repair_T.I. Sign_Sprinkler_Demo lition_Change of Use <br /> DESCRIPTION OF WORK(additional space provided on the back): <br /> h5ial\ ons tip -�-)Ign ckoplci,­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 /> I Forced air systems Bathtub <br /> Gas piping Lavatory(wash basin) <br /> j Water heater j Shower <br /> Gas fireplace i Kitchen sink&disposal <br /> j Gas range i Dishwasher <br /> Clothes dryer j Clothes washer <br /> Range hood Water heater <br /> Exhaust fan Sink(service/bar/mop/etc.) <br /> j Heat pump Backflow preventer <br /> Unit heater Urinal <br /> Boiler Drinking Fountain <br /> Refrigeration Floor drain <br /> Woodstove Grease trap <br /> Ducting Roof drains <br /> Other I 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 complied <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 own 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 /> (/1-, 4t <br /> caner uthorized(!� i nature Date (Revised 3/201 6 <br />