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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: ' PROPERTY TAX# PERMIT# <br /> Heuoiyr Npp,. �C/e/e t I -0 Z <br /> LEGAL for new construction: Short Plat/subdivision �l{S Lot No. (attach copy of long legal description) <br /> OWNER B ��� �l!✓ Phone/E-mail 0(q 4 5s <br /> Address �`�2 a tC J t EV Qfe Z� City/State/Zip <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 /> CONTRACTOR 0\,)ne.( + State Lic.# City Bus. Lic. # <br /> Address Phone/Email J �j �yZeA <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT <br /> -4CA A -Ll 556 /1(1 isc, %A:)Q IIcAOt"c✓*-, � <br /> Phone/E-mail A 1I is J 1 �v <br /> '91 <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK_ 5 — <br /> Existing Use of Building HEAT SOURCE: <br /> Proposed Use of Building A----2, Q t+ti✓7nGas_ Electric Other <br /> Building type: _Single Family _Duplex`_Townhouse _Multi-Family I&Commercial <br /> Type of project: New Addition Remodel _Repair A T.I._Sign_Sprinkler_Demolitiol. Change of Use <br /> DESCRIPTION OF WORK(additional space provided on the back): <br /> S Y��i ` S v`S�n l Cestta,u► exM--. M otA I�t <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type of Project: _New_Addn _Alteration_Repair rype of Project: _New_Addn _Alteration_Repair <br /> Show Number(#)of fixtures Show Number(#)of fixtures <br /> A/C–air handling units Toilet <br /> j Forced air systems Bathtub <br /> j Gas piping j Lavatory(wash basin) <br /> Water heater j Shower <br /> Gas fireplace j Kitchen sink&disposal <br /> Gas range Dishwasher <br /> Clothes dryer Clothes washer <br /> I Range hood Water heater <br /> i Exhaust fan j Sink(service/bar/mop/etc.) <br /> j Heat pump Backflow preventer <br /> Unit heater Urinal <br /> Boiler Drinking Fountain <br /> Refrigeration j Floor drain <br /> Woodstove i Grease trap <br /> Ducting Roof drains <br /> j Other ! Medical Gas <br /> SPRINKLER i SUPPRESSION SYSTEM i Other: <br /> Number of Heads Other. <br /> 1 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 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 /> A41Z74t----- 9 3 <br /> Owner/Authorize a Date (Revised 3/2013) <br />