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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 TAXI/ PE-MIT#Q <br /> 0�aC) c t A <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> OWNER CJS %Z1J �L✓/J3LL S'i"�U Phone/E-mail Li2-5 ! �• 7 '/S/ <br /> Address L/J�� WE: City/State/Zip l cS 4O,' i/—1 1�� /r✓C��(�o7 <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 Co/V\MCLtc o L CaNSpZs-u-p.J Gizr State Lic. # ( O22/ 7cC L 33j ,45ty Bus. Lic.# <br /> Address �- "4.f Ur Phone/Email 2 31 Li773 <br /> TENANTBUSINESS NAME CONTACT FOR PERMIT <br /> fSf7J (C <br /> CIC- Phone/E-mailiti; Grp L, <br /> n.��� Ji'a''1/I /Z)2• /��� <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK — /3,000 <br /> Existing Use of Building v' l 9Cs4v C )£1— J4C.131- Ck)"t HEAT SOURCE: <br /> Proposed Use of Building .S i' Y Gas Electric x Other <br /> Building type: Single Family Duplex Townhouse Multi-Family Commercial <br /> Type of project: New Addition ;Ir\ Remodel Repair T.I. Sign__Sprinkler Demolition Change of Use <br /> DESCRIPTION OF WORK(additional space provided on the back): : C.'XSr I Cr r� €)")5 <br /> M3) (s`n--.`- CjWTnc,t_ Maui vwc <br /> 1 p /0 )�, .70 r,0,v7r of -orr' - <-)r-K <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type of Project: _New_Addn Alteration_Repair Type of Project: _New_Addn t ' Alteration_Repair <br /> Show Number(#)of fixtures Show Number(#)of fixtures <br /> j A/C—air handling units I Toilet <br /> Forced air systems _ Bathtub <br /> Gas piping j Lavatory(wash basin) <br /> Water heater j Shower <br /> Gas fireplace ; Kitchen sink&disposal <br /> Gas range j Dishwasher <br /> Clothes dryerI Clothes washer <br /> _ <br /> Range hood 4—• Water heater <br /> Exhaust fan Sink(service/bar/mop/etc.) <br /> Heat pump Backflow preventer <br /> j Unit heater j Urinal <br /> Boiler j Drinking Fountain <br /> Refrigeration j Floor drain • <br /> Woodstove Grease trap <br /> j Ducting Roof drains <br /> Other ! Medical Gas <br /> SPRINKLER / SUPPRESSION SYSTEM j 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 n..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 a •• •• • the own,r of th"•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 /> _ 1I <br /> Pinto /Ravised3/2013) <br />