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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 /> 728 £W t 9 ���7c��c p 50 I <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> OWNER AeD7774' , e. G(G 'dJ Phone/E-mail /?'(l- t J2r7 <br /> Address '7Zi? (W z (r'/ City/State/Zip E{) y��u114. 91zz <br /> APPLICANT:_Owner _Owner's Agent )( Contractor _Contractors Agent _Tenant(must provide a letter of consent from the owner to do work in the space) <br /> CONTRACTOR t)F Ff7- //gy�pp �L f2 `/I. State Lic.# , i/Ejet 331 fit/ City Bus. Lic.# <br /> Address/ ,(1 gig y>j�—0 /), �, Phone/Email 4'ZS 35 —714, <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT 49)gOrr 6e€iG, e,c /A-2c <br /> Beed/eV Phone/E-mail 4Nc::. �U�i,�CT-j--hjLDh5 (.VCS eta' <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK <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 /> 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 I Toilet <br /> Forced air systems I Bathtub <br /> Gas piping Lavatory(wash basin) <br /> { Water heater I Shower <br /> Gas fireplace Kitchen sink&disposal <br /> Gas range I Dishwasher <br /> Clothes dryer Clothes washer <br /> Range hood Water heater <br /> Exhaust fan • 1 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 I Roof drains <br /> Other j Medical Gas <br /> SPRINKLER / SUPPRESSION SYSTEM j Other: frid $ij <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 thorized 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 /> a/ir& 44"Gg- <br /> Owner/Authorized Agent Signature Date (Revised 3/2013) <br />