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° PE <br /> .MIT APP UCA,T ✓ ,1 <br /> BUILDING/ EC1=1Ar 1CAUPLUMBING/SIGN/SPRINKLER/DEMOU` ION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 Cedar St., Everett,WA 98201 425-257-8810 FAX 425-257-8857 www.everettwa.org <br /> r <br /> SITE ADDRESS "PROPERTY <br /> / 6ov e,�a, .54. f 3S'?-33o o , e c o / I f 'l0 n <br /> • LEGAL for new construction: Short Plat/subdivision BL/< 33o b-o O Lot NoPq`i' O(attach copy of long legal description) <br /> OWNER (_«, Phone/E-mail <br /> Address 3 _ I 6-5--'. 7 S!x- } 4 (1908;1 ._City/Stete/Zip _ <br /> APPLICANT: ,Owner _Owner's Agent Contractor _Contractor's Agent Tenant(must provide a letter of consent from the owner to dp work In the space) <br /> CONTRACTOR Ow V(-PiffState Lie.# ccC��ity Bus. Lic.# <br /> Address (Phone/Email log,1 Sa.10 5'y oat•e.n�, <br /> TENANT BUSINESS NAME " ' CONTACT FQR PERMIT • <br /> Phone/E-mail Jo A . S'Qlo (qi) 7d/- y!/d <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK 2510.oa <br /> Existing Use of Building -r-l2-:- HEAT SOURCE: <br /> Proposed Use of Building ' e.----- Gas_ Electric r <br /> Othe <br /> Building type: 7e Single Family —Duplex Townhouse Multi-Family _Commercial <br /> Type of project: —New Addition _Remodel .Repaii_,_T.I._Sign Sprinkler_Demolition Change of Use <br /> DESCRIPTION OF WORK(additional space provided on the <br /> Jback): QB , 14. f vee ��� Woe". <br /> 2. Re&,, itt:/( "ea;/# . .rJ/ 77.40 4c wood, - / <br /> y .,v,'74 r{.s/d h.pe. / bv,'/S ., 40 4., •a / <br /> • <br /> &I big C L PERMIT / PLUMBING PERMIT APPLICATION <br /> MECHANICAL APPJ(,I�jgTi(ON <br /> Type of Project: New Addn _Alteration Repair Type of Project: New Addn Alteration_Repair <br /> Show Number(#)of fixturesShow Number(#)of fixtures • <br /> NC—air handling units Toilet . <br /> Forced air Systems . Bathtub <br /> • <br /> Gas piping • <br /> Lavatory(wash basin). <br /> 1 Water heaterShower • <br /> • • "� Gas fireplace . Kitchen sink&disposal . <br /> I Gas range Dishwasher . <br /> Clothes dryer • Clothes washer <br /> 1 Range hood Water heater <br /> Exhaust fan Sink(service/bar/mop/etc.) <br /> I Heat pump Backflow preventer(inside bldg) <br /> Unit heater Urinal <br /> � Boiler :I Drinking Fountain <br /> Refrigeration Floor drain <br /> • <br /> • <br /> Woodstove • <br /> Grease trap _ . <br /> 1- Ducting Roof drains <br /> Other • Medical Gas <br /> SPRINKLER I SUPPRESSION SYSTEM Other. <br /> � ( . ._ <br /> I 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 <br /> beues mplied <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 on <br /> sThat 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 WAG. <br /> - la _ _�, ---- a (Revised 4/2015) <br /> ."rel/' `rze.�'ge `ig <br /> \I <br />