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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 /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> SITE ADDRESS: PROPERTY TAX# PFERMIT# �7 <br /> 2.7 Zo AA 6 W t A vefS ' s 00 &2,3 00 C)�- <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) SC <br /> arc•5 ra c C s(moo-f-a l• c vvtl <br /> OWNE Phone/E-mail 2 _ Z <br /> Address -70 Styr City/State/Zip r <br /> APPLICANT: Owner Owner's Agent Contractor Contractor's Agent _X Tenant(must provide a letter of consent from me owner to do work in the space) <br /> CONTRACTOR L&I Lic.# 4A COE Bus. Lic.# L 3 <br /> 7pz- <br /> Address 6, <br /> W A- eJ PhonkL5 e/Email rifj D(' r-,-,- <br /> TENANT <br /> -,TENANT BUSINESS NAME CONTACT FOR(PERMIT S�ab�►5on�e 5-deli A.0661 <br /> Il GCeL4CE06" i::saA, �44t! 7, �n X11 <br /> Phone/E-mail y,p 23- ,t t{ <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK 2942 42 <br /> K <br /> Existing Use of Building O eco uhe_�I"'- I <br /> Oil X d - ZFeHEAT SOURCE: <br /> Proposed Use of Building T, 1.- -agd1 4 Lei—, C70;7QG e Gas_K Electric Other <br /> Building type: Single Family _Duplex_Townhouse >4 Multi-Family -y Commercial <br /> Type of project: New Addition Remodel Rep T.I._Sign_Sprinkler_Demolition Change of Use <br /> DESCRIPTION OF WORK(additional space provided on the back): <br /> t A'i e3u',Liao f 0 f' ne,j 5treet leQGl -te-oZ7 i mein -Fvr- 00,�, 6r..,� lz�," 4 <br /> lGt4 p< Gee , IrjLCt-��-x-`i,UAet,1 -1A-te,rirJc fA t-k--,A-5 <br /> tl A4k Stro.,kL,ne . <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 air systems 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 <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 if 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 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 /> t <br /> Owner/Autonzed Agent Signature Date (Revised 6/2012) <br />