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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 />241? Gh'SC�.1[.1'[' S"r. <br />PROP RTY TAX If <br />cD46'13—oo5-Do7-�° <br />PERMIT # <br />05—UI5 <br />LEGAL for new construction: Short Plat/subdivision R n I G 105 Lot Noll$ (attach copy of long legal description) ✓ <br />OWNER G f LM A 1 N Vf,5-rPW PT L A C <br />Phone/E-mail <br />Address P 0. F�Oi( 52-7.2 <br />City/State/Zip I a 5a9 �SZ2z, <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 Lt)ll.j <br />State Lie. # City Bus. Lie. # <br />Address <br />Phone/Email <br />TENANT BUSINESS NAME <br />CONTACT FOR PERMIT <br />IO lc& p . R I - qqg, <br />Phone/E-mail <br />BUILDING PERMIT APPLICATION <br />CONTRACT PRICE OF WORK 1157, 00 <br />Existing Use of Building '5 t— T HEAT SOURCE: <br />Proposed Use of Building SFt- Gas Electric ✓Other <br />Building type: _ Single Family _ Duplex _Townhouse _ MuIZi.�amily _ Commercial <br />Type of project: New Addition Remodel Repair � T.I. Sin Sprinkler Demolition Change of Use <br />DESCRIPTION OF WORK (additional space provided on the back): <br />Pt" P20 oP' r--*"VMA-ct 6 <br />i <br />MECHANICAL PERMIT APPLICATION <br />PLUMBING PERMIT APPLICATION <br />TypeofProject: <br />Show <br />_New_Addn —Alteration _Repair <br />Number (#) of fixtures <br />TypeofProject: _New_Addn _Alteration —Repair <br />Show 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 ran a <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 [hat 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 penult does not presume to give aulhoilty to violate or cancel the provlslon 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 Slate Contractors Law 18.27 RCW and 296.200A WAC. <br />Owne Authorized Agent ignature Date (Revised 9/2014) �� <br />