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PERMIT APPLICATION <br />IS <br />BUILDING/MECHANICAL/PLUMBING/SIGN/SPRINKLER/DEMOLITION <br />CITY OF EVERETT PERMIT SERVICES <br />is <br />3200 Cedar St., Everett, WA 98201 425-257-8810 FAX 425-257-8857 www.everettwa.org <br />SITE ADDRESS: 71� 2 <br />C1� ERTYTAX# �O <br />V <br />LEGAL for new construction: Short Plat/subdivision <br />Lot No. (attach copy of long legal description) <br />OWNER [.-01MJ2 �p <br />Phone/E-mail Z <br />Address 771-7 645c4veFDIZ. <br />City/State/Zip FVFAIC-TJ LVAF <br />APPLICANT: —Owner _ Owner's Agent Jx Contractor —Contractor's Agent _Tenant (must provide a letter of consent from the owner to do work in the space) <br />CONTRACTOR :- <br />State����Liic. # N'" l� L City Bus. Lic. # <br />-�-Al <br />Address /601/ 15� A-ir�e. tJA) <br />c <br />Phone/Email %tZ,�;-77!;�6 6 <br />TENANT BUSINESS NAME <br />CONTACT FOR PERMIT p„ 1 <br />Phone/E-mail ZS-77.5--6ell,,� <br />BUILDING PERMIT APPLICATION <br />CONTRACT PRICE OF WORK V, 1474 1 CO <br />Existing Use of Building <br />HEAT SOURCE: <br />Proposed Use of Building <br />GasA Electric_ Other <br />Building type: � Single Family _Duplex _Townhouse _ <br />Multi -Family _Commercial <br />of project: _New _L Addition _ Remodel _ Repair <br />_ T.I. —Sign _Sprinkler _Demolition_ Change of Use <br />iType <br />)ESCRIPTION OF WORK (additional space provided on the back) : <br />ej�-49L-4 C-C 64577NC �i2 - �c� �`�-L�� Bp?L <br />LL'/ � A- &i 2u) �sv <br />NP.w C-r&S PJPi,AJ q- <br />MECHANICAL PERMIT APPLICATION <br />PLUMBING PERMIT APPLICATION <br />Type of Project: _New _AddnAlteration _Repair <br />Type of Project: _New _Addn _Alteration _Repair <br />Show Number (#) of fixtures <br />Show Number (#) of fixtures <br />A/C - air handling units <br />Toilet <br />I Forced air systems <br />j Bathtub <br />Gas piping <br />Lavatory (wash basin) <br />Water heater <br />l Shower <br />Gas fireplace <br />Kitchen sink & disposal <br />Gas range <br />Dishwasher <br />j Clothes dryer <br />i 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 />j Boiler <br />Drinking Fountain <br />Refrigeration <br />j Floor drain <br />Woodstove <br />Grease trap <br />Ducting <br />Roof drains <br />Other <br />Medical Gas <br />SPRINKLER / SUPPRESSION SYSTEM <br />! Other: <br />Number of Heads <br />Other: <br />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 />Owner/ thorized Agen ign a Date <br />(Revised 312013) <br />�/L <br />