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46RMIT APPLICATIA <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# PERM <br /> _S`(vL{ 00 <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> OWNER :70 pA e!9 Phone/E-mail 2 5'356 -3y FS L. Hsu r LE S U I, <br /> Address .V 9 b y F e ck,,2� t-% I e City/State/Zip v :z a e.7� VJ A G!E�bkl <br /> APPLICANT: Owner _Owner's Agent �L Contractor _Contractor's Agent _Tenant(must provide a letter of consent from the owner to dp work in the space) <br /> CONTRACTOR 1�.�1 - ,r L�i� G�� ` State Lic.# City Bus. Lic.# <br /> Address Li 3 Z o 1 3 t 5} P L_ cSv t{� l V U c e,-Ai�e, tJA Phone/Email 'Z 04, ` to3 Z–&D`L'O <br /> TENANT BUSINF55 NAME CONTACT FOR PERMIT 6 CALL <br /> Y,(-� L--e L <br /> Phone/E-mail J L -i. . Ler .�os <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK 7B, 5oc, <br /> Existing Use of Building �� S r 7,777, HEAT SOURCE: <br /> Proposed Use of Building Gas_ Electric_ Other'IO u i L-- <br /> Building type: -1l4- Single Family _Duplex_Townhouse _Multi-Family _Commercial <br /> Type of project_New _Addition _Remodel Y—Repair_T.1._Sign_Sprinkler_Demolition_Change of Use <br /> DESCRIPTION OF (WORK(additional space provided on the back): <br /> t ( j2sz P A- Yl_ tL4_1 N O; T-tr V c5w <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type of Project: _New_Addn _Alteration Repair Type of Project: —New_Addn —Alteration_1�-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(inside bldg) <br /> Unit heater Urinal <br /> 7( Boiler Drinking Fountain <br /> I Refrigeration Floor drain <br /> Woodstove ! Grease trap <br /> I Ducting Roof drains <br /> Other Medical Gas <br /> SPRINKLER / 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 /> Owner/ A ature Date l/ (Revised 4/2015) <br /> ° Z <br />