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PERMIT APPLICATICSi <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: PROPERTY TAX# ERMIT# <br /> .tel E.. SGC,/Z i, Lvi5"bK'- -coos <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> OWNER /,G/ �e" Phone/E-mail ( 064) 7/i-- Utz r,r /1 `�a`r � <br /> Address / g c/l G # 4,7 ,y •, 0,Gc, 1:1 ity/State/Zip <br /> APPLICANT: Owner _Owner's Agent • Contractor _Contractor's Agent _Tenant(must provide a letter of consent from the owner to rip work In the space) <br /> CONTRACTOR G;,je€ %�C1 hoe. ,Kr- 1.. State <br /> Lic.# /Z ZG g Tek" CityBus, LLic.�! A/Address J Y. 260 lo�r 71,, y . / 5 d1 / 7 ') -2 Phone/Email (`y2,7)232(/7 Tet/(:/ 9 <br /> /+Kci/ <br /> USINESS <br /> NAME CONTACT FOR PERMIT J I N� E .Ce.-1-41 <br /> `` • <br /> //-0 t <br /> (!/: (C2 7 ,�iGic 4.— she_' i' Phone/E-mail , 67 >7- �'3 7 r 4 7�r 6 <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK Yi�r��G i <br /> Existing Use of Building C4,,,c- 4 Q HEAT SOURCE: <br /> Proposed Use of Building <S/f'1cX� L <br /> 5nr /'e T1- / , Gas Electric ;/e Other <br /> Building type: Single Family _Duplex_Townhouse Multi-Family /Oommercial <br /> Type of project: New Addition Remodel _Repair 1//1-.I. Sign Sprinkler Demolition Change of Use <br /> DESCRIPTION OF WORK(additional space provided on the back): <br /> x QL.J/ j e tic, /i i . •,mss.. .,•? �', 7 �/vr/ <br /> Kc-7`4 / s�e-ce-. ) ,NS71 .L 2tA1) EICIf rN,+bC-otic-I9c - <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type of Project: _New Addn s teration_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 Bathtub <br /> Gas piping Lavatory(wash basin) <br /> Water heater i Shower <br /> Gas firepla 5L/ Kitchen sink&disposal <br /> • <br /> Gas range l'.1 / Dishwasher <br /> Clothes dri(er �,�I, Clothes washer <br /> Range hood e. LP ���444JJJ Water heater <br /> Exhaust fan-\,. • l 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 I Grease trap <br /> Ducting I Roof drains <br /> Other Medical Gas <br /> I SPRINKLER / SUP3'RESSION SYSTEM i Other: <br /> Number of Heads Other: <br /> 2 <br /> I here ce 'y 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 hether 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 I am authorized by th caner of this property to perform the work for which applicatio is made and I comply with the State Contractors Law 18.27 RCW and 296.200A WAC. <br /> 7pirt—elrAIrthried Agent Signature ate (Revised 4/2015) <br />