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asap due �'' <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.everetma.org <br /> SITE ADDRESS' / e PROPERTY TAX# ^ P MIT# <br /> 7G U L� `7 7,/ <br /> LEGAL for new construction: Short Plattsubdivision Lot No.-3!6 (attach copy of long legal description) <br /> OWNER r� VffipfAa <5 Phone/E-mail <br /> Address /gVle &ejr4Ro90City/State/zip <br /> APPLICANT:_Owner _Owner's Agent AContractor _Contractor's Agent _Tenant(must provide a letter of consent from the owner to do work in the space) <br /> CONTRACTOR g� e SYLiC State Lic.# Qi'$ t City Bus. Lic.# <br /> Address Al 2-7 �, C Phone/Email 72 <br /> TENANT BUSINE S NAME CONTACT FOR PERMIT Low <br /> � , Al i 6-A r�r Sen e �rna,r/•� <br /> 197y&c Phone/E-mail <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK I TOr D 00 <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 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 /> h) ba lC-W7 - 4C w+/� <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION r �" <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 i Drinking Fountain <br /> Refrigeration Floor drain <br /> Woodstove Grease trap <br /> Ducting Roof drains <br /> Other I Medical Gas <br /> SPRINKLER / SUPPRESSION SYSTEM I Other: <br /> Number of Heads I Other: <br /> I nereby 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 slate or local law regulating construction <br /> That I am authorized by the owner of this property to perform the work fo/which plication is made and I comply with the State Contractors Law 18.27 RCW and 296.200A WAC. <br /> Owner/A thorized Agent Signature 7Dae (Revised 3/2013) <br />