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• • <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 /> SITE ADDRESS: PROPERTY TAX# PERMIT# <br /> 2130 61 1 709' 2S'0 S2Voo2cr roc <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> OWNER 'RiiyL 7rpnd (v-<A) IZ2 <br /> , Phone/E-mail42S-29,4 7909 <br /> Address J530 /k , #7 V_ S� City/State/Zip ?��f� ^, 578(�O� <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 , Fr tQ t� '1' City Bus. Lic.# <br /> State Lic.# <br /> Address,V0 t3ex ft, y 7err- tle uA 1IS'Gy3 Phone/Email <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT <br /> Phone/E-mail <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK <br /> Existing Use of Building '�611r, -- xzs�rrrif' l" HEAT SOURCE: <br /> Proposed Use of Building Gas Electric Other <br /> Building type: X Single Family _Duplex_Townhouse _Multi-Family —Commercial <br /> Type ofproject: New Addition Remodel Repair T.1. Sin Sprinkler 5C Demolition Chane of Use <br /> DESCRIPTION OF WORK(additional space provided on the back): <br /> J)em D eX;h.J1.4Sc sou e-7U KP- <br /> MECHANICAL <br /> eMECHANICAL 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 airs stems Bathtub <br /> Gas pipingLavato 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 pumpBackflow 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 / 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 comp) <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 a horize by the owner of this property to perform the work for which application is made and I comply with the Stale Contractors Law 18.27 RCW and 296.200A WAC. <br /> wnerl u Igna ure Date (Revised 9/2014) <br />