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PERMIT APPLICATIM% <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 A )DRESS: PROPERTY TAX# PERMIT# <br /> •- Z . /SPC/- J)(4-Y • ez(AlI607-P9t 3 <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> OWNER V i 6-I`Z'-r- Phone/E-mail f� <br /> Address4)Z 3" i%2_C v(F2 /�C�� ,. City/State/Zip tll�zr� )4- (-77 - <br /> L&/• <br /> APPLICANT: Own 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 p ifs(4t" State Lic. # City Bus. Lic.# <br /> Address Phone/Email <br /> CONTACT FOR PERMIT <br /> ;12e---i2.--2. If/5(e�-rer 4-2S-4jg .s65� <br /> Phone/E-mail - r Qr'j// Cr'-trC r4/-/�D.CO' <br /> BUILDING PERMIT APPLICATION CONTRACT PRICEOFi--7 <br /> WORK r,,, -OOc -✓ 9.-©P . <br /> Existing Use of Building 72 G / Pe-7c 7/12_ HEAT SOURCE: <br /> Proposed Use of Building R L -?-2.7 Gas Electric Other <br /> Building type: ,Single Fa limy 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 /> ! 04 40. ,,qlti t 'y 0 ft-1,c i,3 a: -72 S r t--GJ f -- /( - <br /> 1 i , .. — I'�c-�3/r(c jA& d1,r & rr# 6 c'r,F��. <br /> >2cv(i_f 1N1c,itiuL (1 1%- N•rt 00`w+^e4/1 L._O& - L/O pen- PIr, <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 /> A/C-air handling units Toilet <br /> Forced air systems /ZF1w12: Bathtub <br /> Gas piping Ig 14-F Lavatory(wash basin) <br /> 1 Water heater Shower <br /> Gas fireplace Kitchen sink&disposal <br /> Gas range Dishwasher ' <br /> •.)0- ✓ Clothes dryer R-Di) ✓ Clothes washer <br /> I Range hood r/ Water heater <br /> Exhaust fan Lzc° : I Sink (service/bar/mop/etc.) <br /> _ Heat pump Backflow preventer(inside bldg) <br /> Unit heater Urinal <br /> Boiler Drinking Fountain <br /> 1 Refrigeration Floor drain <br /> 1 Woodstove I Grease trap <br /> 1 Ducting I Roof drains <br /> Other Medical Gas <br /> SPRINKLER / SUPPRESSION SYSTEM I 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 complied <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 /> That 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 WAC. <br /> 2Y//,S.'--Owner/AA:Li-ffi ed-Agent Signature te ' (Revised 4/2015) <br /> L1� <br />