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PERMIT APP1JCAT UN <br /> MILDIf G/MECHA 9Ic AL/PLUI BING/BION/SPRIb KLEI /®EMOUQTION <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# PERMIT# <br /> SZI6 i ri4 s IN\049()? a <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) • <br /> OWNER 130y 5 6kJ-b C bola Phone/E-mail t12e- 2-51- ,�/'i7 . . <br /> Address 23(6, ( Z £j ( ., • City/State/Zip j!/E/Zc 7 l.v4 9S20/ . <br /> APPLICANT: OwnerA _Owner's Agent Contractor _Contractor's Agent _Tenant(must provide a letter of consent from the owner to dp work In the space) <br /> CONTRACTOR 6 V - e(fir - A. it titT — State Lic.# Et -S` OZ.2i l City Bus. Lie.# 00.1`255 • <br /> (S <br /> Address 2_t-2....0 $C-t`tL Au 6,. J [AA ciO D I Phone/Email L Zj -2_ 2----3 t 8 L <br /> TENANT BUSINESS NAME ' CONNTTjACT FOR PERMIT 114,k@. 69i4xiiei -e�� <br /> (3r <br /> go g5 Z v/5 /�L-LU1 Phone/E-mail Lf2j-252_- 3/f0 <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK .5-00 <br /> • <br /> Existing Use of Building /V 6 C %l6`+7k%(:i; HEAT SOURCE: • <br /> 4,0 <br /> Proposed Use of Building N © C µj1,6. Gas '‹ Electric Other <br /> Building type: —Single Family ^Duplex Townhouse _Multi-Family x Commercial <br /> Type of project: _New Addition _Remodel ,X Repair T.1._Sign Sprinkler Demolition Change of Use <br /> DESCRIPTION OF WORK(additional space provided on the back): ,'/1,46- tC� !�! !- AJ <br /> t�ovoub t (�lxt5l� 6: wv� 4b evr7HP / r <br /> 1v(o coktb6 16 Du Cr i.da-/L cf toE-1oqucr <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type of Project: _New_Addn _Alterationf 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 /> • <br /> Gas rangeDishwasher ' <br /> Clothes dryer Clothes washer • <br /> Range hood Water heater <br /> Exhaust fan i Sink(service/bar/mop/etc.) <br /> Heat pump Backflow preventer(inside bldg) <br /> Unit heater Urinal - <br /> Boiler Drinking Fountain <br /> Refrigeration I Floor drain <br /> Woodstove Grease trap <br /> Ducting I Roof drains ' ' ' <br /> Other Medical Gas <br /> SPRINKLER I 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 a r= t orized 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 - t iz.+ p.ent Signature Date 4,‘,06j (Revised 4/2015) <br />