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• <br /> 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 /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> SITE ADDRESS: c-ACkt-&%•PteK- Ser tad' C4•%•••••4Ate PROPERTY TAX# PERMIT# <br /> 302S- Low004.4 q.,e ow o713o05DO i3o(e-& <br /> LEGAL for new construction: Short Plat/subdivision _Lot No. (attach copy of long legal description) <br /> OWNER C.'Ct'l Q E 4ey- 44.. Phone/E-mail 6-z.$) L6'1 - -889 (p <br /> Address 31O\ Cedr„- SA. . City/State/Zip ��er�4-\- Li ya 1126 <br /> APPLICANT:_Owner Owner's Agent _Contractor _Contractor's Agent Tenant(must provide a letter of consent from the owner to do work in the space) <br /> CONTRACTOR <br /> [-ie.-id A. Ly GcERhop,1n4_&I Lic.# (ooO O(a( p <br /> (7 COE Bus.Lic.# <br /> Address 21% Z$ g 11A" WJE SE STe F Phone/Email 4zc•L gs•6s-14p/61.0,00 l ct hoick.c -i <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT <br /> «Is.t 6.444 bFn)la& CT.VJT L kASoev.. SAis)c1+EZ t FAO • bre Pi'.. <br /> cACy a F E.06 ,err Phone/E-mail 88Lce /rSc.Kc.l,tet COQ(e'ttWc%• )00• <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK 27+, O',C) <br /> Existing Use of Building ASS ern Ly HEAT SOURCE: <br /> Proposed Use of Building 4/114 Gas Electric Other <br /> Building type: _Single Family _Duplex Townhouse Multi-Family X Commercial <br /> Type of project: _New Addition Remodel X- Repair_T.I._Sign Sprinkler_Demolition_Change of Use <br /> DESCRIPTION OF WORK(additional space provided on the back): beNwo eXkS4 Y00q,•Th r^A..+.ur' <br /> t cY‘cic..42ASI'r! Avuecr4ei0tn43 5\oip\.hk . APPS`( VW-L.0 1ro0''te . •e)(IS4-irS <br /> S1c./ s * reNlac e w ,se-w CAC- ji c dow.e Sk•{ lr� h4- <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 Lavatory(wash basin) <br /> Water heater Shower <br /> Gas fireplace Kitchen sink&disposal <br /> Gas range Dishwasher <br /> Clothes dryer Clothes washer <br /> Range hood Water heater <br /> Exhaust fan Sink(service/bar/mop/etc.) <br /> Heat pump Backflow preventer <br /> Unit heater Urinal <br /> Boiler Drinking Fountain <br /> Refrigeration Floor drain <br /> Woodstove Grease trap <br /> Ducting Roof drains <br /> Other Medical Gas <br /> SPRINKLER / SUPPRESSION SYSTEM 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 /> (e //v 1 /3 112._ <br /> Owner/Authorized Agent Signat Date <br /> (Revised 6/2012) <br /> I - - <br />