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1111 <br /> ERMIT APPLICATIOfr <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 /> —IC —I 6 <br /> SIT_QI�JJJDDb ti l oR '^VV00 6A-ve # 14 ( PROPERTY TAX# I tO -0-2-0 <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description)) <br /> OWNER 4--0 V\ PI vtwil.c, Mal-1 Sb V\ Phone/E-mail L 'ZS - 37(--(-'-2-S 3 0 <br /> Address b0 Ci I Vv)pc 1 / 1-t , City/State/Zip Cr.G yell/ w\ Gj g 7`p3 <br /> APPLICANT: Owner Owner's Agent/X Contractor Contractor's Agent (( Tenant(must provide a letter of consent from the owner to do work in the space) <br /> U <br /> CONTRACTOR1.3 I LA--e_ Pi 6tVV1-€ State Lic.#I3LA FF City Bus. Lic.#0s-2---71,L <br /> (a 707'" St W $. !�o h�"!a Ise rr cep i-/��, --1 13 rn <br /> Address S , �l f} OL4 Phone/Email I e1IUe,��k'V'� rf`r�D <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT <br /> -K---60 (6U1\A Mt j 2 <br /> _Phone/E-mail Li 2c- I� I -1 ( J 2 9 <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK y b O <br /> Existing Use of Building HEAT SOURCE: <br /> Proposed Use of Building 7 ' 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 /> St —TC13 ii-V) c e Cha -e-- d u f <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type of Project: _New_AddnAlteration_Repair Type of Project: New Addn Alteration Repair <br /> Show Number(#) f fixtures Show Number(#)of fixtures <br /> A/C–air handling units Toilet <br /> 1 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 /> Clothes dryer Clothes washer <br /> Range hood Water heater <br /> Exhaust fan Sink (service/bar/mop/etc.) <br /> Heat pump Backflow preventer (inside bldg) <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 state or local law regulating construction <br /> Th t I am uthorize y the ner 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 /> — Ui °1 / IIP <br /> 0 ner/Authorized Agent Signatur Date �� (Revised 4/2015) <br />