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w PERMIT APPLICATIOO <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.ev erettwa.or <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> F <br /> DRESS: PROPERTY TAX# PERMIT# <br /> Z y �T �ZD3- '�C1 ,ov3o71v��for,,AAnew construction: Short Plattsubdivision Lot No. (attach copy of long legal description) <br /> OWNER Il +F- F-42aF r Phone/E-mail <br /> V� q City/State/Zip , �19 <br /> Address�T 7 3Z'�r t i/tr. ��I Ia <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 /> CONTRACTORu) G L&I Lic.#.517=�JAf~P 31 COE Bus. Lic.#O ,SO£� <br /> Address j " LuQc.1tG�D. 2 Ph_one/Email of ; L1 <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT �� +1Ae2�1 y=g ,7..Z93 <br /> ATP6 6 �i 9a -T, Phone/E-mail rWAP- `� <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK Ic <br /> Existing Use of Building F`W�Aa.SQ��4C7�2t��1 �+-� iqGi*:L=- HEAT SOURCE: <br /> Proposed Use of Building salM 1'1i' Gas_ Electric_ Other_ <br /> Building type: _Single Family _Duplex_Townhouse _Multi-Family WCommercial <br /> Type of pro ect: New _Addition —Remodel Repair Acolr.l. Sign�Sprinkler_Demolition_Change of Use <br /> DESCRIPTION OF WORK(additional space provided on the back): 6361A-0 <br /> tl � � <br /> A00 �� � --��o,�► 'moo rJG� 1'3 j3�1 O FFu, - <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 /> Dishwasher <br /> Gas range Clothes washer <br /> Clothes dryer <br /> Range hood Water heater <br /> Exhaust fan Sink(service/bar/mop/etc.) <br /> Backflow preventer <br /> Heat pump <br /> Urinal <br /> Unit heater <br /> Boiler Drinking Fountain <br /> Boiler <br /> Floor drain <br /> Woodstove Grease trap <br /> Roof drains <br /> Ducting Medical Gas <br /> Other <br /> SPRINKLER I SUPPRESSION SYSTEM Other: <br /> 1'3)l, 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 /> 9 -Cl-` Date (Revised 6/2012) <br /> Own Authorized Agent Signature <br />