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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: PROPERTY TAX# P. IT# <br /> 332 Sh/ E v e rT- PIA c.( k vAY QO2— bLk <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> OWNER NI•A t toNAC- &ENfPakt, IN6OgANC. Phone/E-mail <br /> Address City/State/Zip <br /> APPLICANT:_Owner . Vwner s Agent _Contractor _Contractor's Agent _Tenant(must provide a letter of consent from the owner to do work in the space) <br /> CONTRACTOR GPt N Y cNST(LVC7fonl State Lic.# t_4rf-jf(,1 / (L7) City Bus. Lic.# L t/.Cr <br /> Address Si OS E Z_oADWAV EYEIP••eTT;Wyk f Phone/Email '}2S—35S—SSo( <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT <br /> RANIA-�t6tvAc C�fT�El2�AC ►NSUI?AN C.� CrH�S � Ghtis•Ycie�r a7 bhl�aYcl�.Ca►+1 <br /> Phone/E-mailyZS--ZSR-0/5(vse) <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK Z w+�llr <br /> Existing Use of Building O Sfii4C HEAT SOURCE: <br /> Proposed Use of Building C f1 C-E S'AC•B • <br /> ll Gas Electric Other <br /> Building type: Single Family _Duplex_Townhouse Multi-Family �C;ommercial <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 /> T 1. o-E exp 6.31; 14 sfary rAfec,e SpAc e TO be vse-d.. RS Vte•-w oCc,'e-e 5 rAe-e • <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 Bathtub <br /> Gas piping I Lavatory(wash basin) <br /> Water heater Shower <br /> Gas fireplace Kitchen sink&disposal <br /> Gas range I Dishwasher <br /> Clothes dryer L Clothes washer <br /> Range hood Water heater <br /> Exhaust fan Sink(service/bar/mop/etc.) <br /> Heat pump I Backflow preventer <br /> Unit heater Urinal <br /> Boiler Drinking Fountain <br /> Refrigeration Floor drain <br /> Woodstove Grease trap <br /> Ducting I Roof drains <br /> Other I Medical Gas <br /> SPRINKLER / SUPPRESSION SYSTEM I Other: <br /> Number of Heads I 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 compl <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 /> L..' 2-12-1 Co <br /> 1/2 <br /> Owner/Authorized Agent Si nature Date (Revised 9/2014) <br />