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• • <br /> PERMIT APPLICATION <br /> BUILDING/MECHANICA L/PLUMBING/SIGN/SPRIN KLER/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: 4, I i PRC 3�TY T�q-OD I _C t a-D PERMIT 1 0,On� <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) l: <br /> /� r <br /> OWNER Scar,? 4 l �L , '7 �J S I Phone/E-mail jo(,-C�cf� ?q / E "i=/Z <br /> Address ' 14-\- Pt City/State/Zip fVeee-bl JJ/i Q <br /> APPLICANT:-Z\wner _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 State Lic.# City Bus. Lic.# <br /> Address Phone/Email <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT <br /> `� raCc7P L)VI"r Phone/E-mail <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK 3 LU <br /> Existing Use of Building /C�Gi/ Gt (G, e- / �` " HEAT SOURCE: <br /> Proposed Use of Building / 2C�ZB9^ - (�Cc}lr'c� '6-er" ;,-'l/' 1 UY-1 Gas_ Electric Other <br /> Building type: Single Family _Duplex_Townhouse _Multi-Family _Commercial <br /> Type of project: New Addition Remodel Repair_T.I._Sign_Sprinkler_Demolition Change of Use <br /> DESCRIPTION OF WORK(additional space provided on the back)" <br /> ivt�J <br /> � e�-� du1t <br /> FJ(\A.1 <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 /> j Gas piping Lavatory(wash basin) <br /> Water heater j Shower <br /> Gas fireplace j Kitchen sink&disposal <br /> j Gas range I Dishwasher <br /> Clothes dryer Clothes washer <br /> Range hood Water heater <br /> Exhaust fan j Sink(service/bar/mop/etc.) <br /> 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 Medical Gas <br /> SPRINKLER / SUPPRESSION SYSTEM i 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 specif 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 orized by the ow er of thi 7pro :ertyo perform the work for which application is made and I comply with the State Contractors Law 18.27 RCW and 296.200A WAC. <br /> ,177 o <br /> Ow Authoriz Age Signature Date (Revised 3/2013) <br />