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PERMIT APPLICATRIV <br /> BUILDING/', ECICANICAL/PPI. .BING/SIGN/SP INKLER/DE ',Q TPD <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 Cedar St., Everett, WA 98201 425-257-8810 FAX 425-257-8857 www.everettwa.Org <br /> r y PROPERTY TAX# PERMIT# 7� <br /> SITE ADDRESS: L�4e� —Vete! Rc'4 y'gz0 51 e I�� �—o V <br /> f,etC l '� <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> ® Phone/E-mail irYi.5r, !J, vill e -00,,,/t JI"lt., 11 <br /> OWNER k.i.�1� -roc_ p _ 1,4 <br /> Addres .1.1;(175.1:a 72,1 kve 5 City/State/Zip / 9 ,'rri f ( 4 y nay <br /> o/ .APPLICANT:_Owner Owner's Agent -,V <br /> Contractor _Contractor's Agent _Tenant(must provide a letter of consent from the owner to dp work In the space) <br /> J0-5141-1.43- <br /> Address <br /> y r� <br /> State Lie.# fiX l 1�, <br /> .I,t � b �(_)t'% < P�L�1 City Bus S�"U <br /> CONTRACTOR ��X►G�ti �U�'r \��l ti �`. '-� ll . ..�`j�f� _ . <br /> Address Z7 3L -154---t[1 =vli'ce -_. ("/'S <br /> LC` ( Phone/Email )'.t tvs•c"- '-\t C;�litieJ , L � <br /> Cr <br /> �'�� 1 CONTACT FOR PERMIT <br /> TENANT-BUSINESS NAME -1:(:‘,_,,„..‘; 1v-tes cf.-XI 6 VA4lvdt(4.4A <br /> ,` 'l-U % L C. , Phone/E-mail /C <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK 4. '4. -. <br /> • <br /> Existing Use of Building t , �1'.:_I ``— HEAT SOURCE: - <br /> r Gas \ Electric Other <br /> Proposed Use of Building (`�{i�l! ��'��. �'-�� ��' ';0;4:41'0l <br /> Building type; Single Family —Duplex_•Townhouse _Multi-Family� !\ Commercial <br /> Type of project: —New Addition _dRemodel _Repair ,"l T.I._Sign Sprinkler Demolition Change of Use <br /> r <br /> DESCR1PT101►I Of WORK(additional space provided on the back): `G r IC Y.� ,...7_,4_, ''<< b`...1 C t.. L <br /> -y-....1 1 '.-E`'<,t~ ` i e...Ae .: �t�U) ,43.. , :, G C C,C,€ iX S ACxe�i +� ¢�r►�15 <br /> C ' <br /> - <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 /> NC—air handling units Toilet <br /> Forced air systems Bathtub <br /> Gas piping I Lavatory(wash basin). <br /> Water heaterI Shower <br /> Gas fireplace Kitchen sink&disposal <br /> Gas rangeDishwasher <br /> Clothes dryerClothes washer <br /> Range hoodWater heater <br /> - Exhaust fan Sink(service/bar/mop/etc.) <br /> Heat pump Backflow preventer(inside bldg) <br /> Unit heater Urinal . ,. <br /> BoilerDrinking Fountain <br /> Refrigeration ( Floor drain <br /> Woodstove Grease trap <br /> Ducting Roof drains <br /> . I Other Medical Gas <br /> SPRINKLER /SUPPRESSION SYSTEMOther: <br /> II 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 296.20DA WAC. <br /> ' <br /> ///— (Revised 4/21715) <br /> Owner/Authorized Agent Signature Date <br />