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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# PEP'9IT# <br /> y39 76-_:.?6,25-(70 OOP <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) / c <br /> OWNER CC&Wr2 G!hA9/L/iUc L 6 7174C)g Phone/E-mail rG.?) G �-Sg33/1>Gr'r/ha r.£ E?� €1 ckt <br /> Address 2667/ 67 , .- S. City/State/Zip` <br /> APPLICANT:/'O Owner _Owners Agent Contractor _Contractor's Agent _Tenant(must provide a letter of consent from the owner to do work in the space) <br /> CONTRACTOR GI.. -Ift e-77/9/2/j/sE'Z... 0.fiDeta, /1 State Lic.# GG��r�Ga/,�? ;;2/".:3-5' City Bus. Lic.#04/5/y�'i,'�` <br /> Address;�6c3/ ' v® ! / i,4 5 /2 ' Phone/Email P CJ � � / <br /> �� �~' tyc_ccn`i Gr r'>C.Jeak✓c:vi P„," <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT c c"� <br /> Phone/E-mail d fn not 5,-f.,2 CPC1*;4 ere/et/E41 <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 X Demolition Change of Use <br /> DESCRIPTION OF WORK(additional space provided on the back): '-6..-/-7j0 ./7/G, A /26,9-7ev.9 <br /> Com/ i jy — /A%C--6f-'-S w 2 /6 /3 4 iir7- GJi./c=/2✓4GL <br /> r er'e -7.- : S' ✓�c �✓�i�'�,r9`g /36- /2(1- '70(-e4.9/1 'i24 5 <br /> /-- 0 c72 tc.3/Ls/t/-Fe.--r "/G/z '?t ezio, 4" <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 Bathtub <br /> Gas piping _ 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 Backflow preventer <br /> Unit heater Urinal <br /> Boiler Drinking Fountain <br /> Refrigeration i Floor drain <br /> Woodstove Grease trap <br /> Ducting Roof drains <br /> Other j 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 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 /> (7-Delw -2 /9,4©' <br /> Owner/Authorized Agent S- nature Date (Revised 9/2014) <br />