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0 i <br /> PERMIT APPLICATION <br /> BUILDING/MECHANICAL/PLUMBING/SIGNIS PRI NKLER/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#Z v I c�7 PERMIT# <br /> � E'sW- "MI 2 aysl�v�3ozz°V � <br /> qZ() �q2 - 0 <br /> IL <br /> LEGAL for new construction: Short Plat/subdivision -.N121 Lot No. (attach copy of long legal description) �;e c <br /> OWNER 6INT—( .f.. Pit( JoclL € (3"-A/F Phone/E-mail qZs 153 <br /> Addressqao 92 Vt <•4 City/State/Zip 6)e,v- , <br /> `r L C <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 /> CONTRACTOR t j Yvi pwr State Lic.# _ City Bus. Lic.# <br /> Address Phone/Email <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT <br /> Phone/E-mail t/ 61( �Ifi��v c'Sr i✓l/l <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK <br /> Existing Use of Building S HEAT SOURCE: <br /> Proposed Use of Building N � �C= tiL L' _ GasElectri0c Other_ <br /> Building type: x Single Family _Duplex_Townhouse _Multi-Family _Commercial <br /> Type of project: New Addition Remodel _Repair_T.1._Sign__Sprinkler X Demolition_Change of Use <br /> DESCRIPTION OF WORK(additional space provided on the back): <br /> l I'07C) �Z - 6 <br /> + �U X33 1 :3-001ry <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 i_ Lavatory(wash basin) <br /> Water heater Shower <br /> Gas fireplace j 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 I Backflow preventer <br /> Unit heater Urinal <br /> Boiler Drinking Fountain <br /> Refrigeration j Floor drain <br /> Woodstove Grease trap <br /> Ducting Roof drains <br /> Other ! Medical Gas <br /> SPRINKLER / SUPPRESSION SYSTEM j 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 ranti 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 authonze�)y the owner of t s prop rfy to perform the work for which application is made and I comply with the State Contractors Law 16.27 RCW and 296.200A WAC. <br /> // { <br /> 2 <br /> 1/2- <br /> Own iA tforized en ignature Date (Revised 3/2013) <br />