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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: <br />�4' �� t�.5T� yr T <br />PROPERTY TAX # <br />��C> �� ��o <br />PE IT #� <br />E, ) i <br />LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br />OWNER C—[2- 4 LLG <br />Phone/E-mail ?J(pQ -- -%D I q g�j~ <br />�(/.1(iis/�/Li%i,UT <br />Address (), ► L,)x �;5 Z Z i tr <br />f - <br />City/State/Zip U t 9d qz)q <br />APPLICANT: —Owner — Owner's Agent _Contractor —Contractor's Agent _Tenant (must provide a letter of consent from the owner to do work in the space) <br />CONTRACTOR �. !� <br />State Lic. # City Bus. Lic. # <br />Address <br />Phone/Email <br />TENANT BUSINESS NAME <br />iiliva,uCE 2EM 1,<'.�- Sa✓.�tTIDNS,�t_c. <br />CONTACT FOR PERMIT. <br />Mt&O-AOL, VA-L[Ba1 M <br />Phone/E-mail ZDb 42-) 3h �y �t°oiga e <br />BUILDING PERMIT APPLICATION <br />CONTRACT PRICE OF WORK <br />Existing Use of Building 1iAZjk1 r HEAT SOURCE: <br />Proposed Use of Building `7� 02— Gas_ Electric_ Other <br />Building type: Single Family _ Duplex _Townhouse _ Multi -Family _ Commercial <br />Type ofproject: New Addition Remodel Repair T.I. Sin Sprinkler Demolition Change of Use <br />DESCRIPTION OF WORK (additional space provided on the back): <br />r12E IZ�OA"l/L TD SIrGTlvN of P-OCI -. <br />pfYl2 (_r'ar►2 PJ,2% <br />MECHANICAL PERMIT APPLICATION <br />PLUMBING PERMIT APPLICATION <br />Type of Project: _New <br />Show <br />_Addn _Alteration _Repair <br />Number (#) of fixtures <br />Type of Project: <br />Show <br />_New _Addn _Alteration _Repair <br />Number (#) of fixtures <br />A/C — air handling units <br />Toilet <br />Forced airs stems <br />Bathtub <br />Gas piping <br />Lavatory wash basin <br />Water heater <br />Shower <br />Gas fireplace <br />Kitchen sink & disposal <br />Gas range <br />Dishwasher <br />Clothes dryer <br />Clothes washer <br />Range hood <br />Water heater <br />Exhaust fan <br />Sink (service/bar/mop/etc.) <br />Heat pump <br />Backflow preventer <br />Unit heater <br />Urinal <br />Boiler <br />Drinking Fountain <br />Refrigeration <br />Floor drain <br />Woodstove <br />Grease trap <br />Ducting <br />Roof drains <br />Other <br />Medical Gas <br />SPRINKLER <br />/ SUPPRESSION SYSTEM <br />Other: <br />Number of Heads <br />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 slate 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 Slate Contractors Law 18.27 RCW and 296.200A WAC. <br />Owner/Authorize Agent Signature Date (Revised 912014) <br />C 60 15'0 3 <br />