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III <br /> R <br /> RMIT 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 /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM a 4 <br /> SITE ADDRESS: PROPERTY TAX PERMIT# <br /> -'61,6 &. Cos i r o Imo R . c3(,l 5 I # I ca1(002- S G2- <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> OWNER Phone/E-mail <br /> Address City/State/Zip <br /> CONTRACTOR j 54T Stan S21fV tC£J L&I Lic.# etarsIs ir (19'0 f fl <br /> Address IID2IZ jr}I U-Evecet} they I"231 In111 Gree.VA- 99o12 Phone/Email 2/25.33o.$It,O bbisigr►.srr��nasa.cor^>t <br /> TENANT BUSINESS NAME ,�,,},1V( .'SCONTACT FOR PERMIT <br /> Frane- <br /> 1 i le. I, rI Oe h1- Thr/1 Phone/E-mail 4125.3W.91k, bbt Yi --4YIS'rl•Cd" <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK 3t ,me) <br /> Existing Use of Building 05rYi Yne-rC- 4,l HEAT SOURCE: <br /> Proposed Use of Building 14/A Gas Electric_ Other <br /> Building type: _Single Family _Duplex Townhouse _Multi-Family X 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 /> InSibAt LED WO,AX Stbr) oAspk& t / 4, <br /> t51()141 <br /> Have you started working without a permit? YES 24 NO Gbh O <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 /> NC-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 /> — <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 /> — <br /> Boiler Drinking Fountain <br /> — <br /> Refrigeration Floor drain <br /> Woodstove Grease trap <br /> — <br /> Ducting Roof drains <br /> — <br /> Other Medical Gas <br /> SPRINKLER/SUPPRESSION SYSTEM Other <br /> — <br /> Number of Heads _ <br /> I hereby certify that I have read and examined this application and know the same to be true and correct.Ail provisions of laws and ordinances governing <br /> this type of work will be complied with whether specified herein or not.The granting of a permit does not presume to give authority to violate or cancel <br /> the provision of any other state or local law regulating construction or the performance of construction.That I am authorized by the owner of this property <br /> to perform the w for which appl'>- , is made and I comply with the State Contractors Law 18.27 RCW and 296.200 WAC <br /> is <br /> Own ti , orized Agent SI, Date (Revised 12/2010) <br /> 14 <br /> A6. <br />