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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 ft PERMIT# <br /> zLEGAisg5 75-11-‘ St 5' b 13C S -07.-- <br /> LEGAL <br /> L for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> OWNER )0h1150A pr 4,.e j t. u-- Phone/E-mail 41 5 ..SZZB-/(,70 <br /> 'G <br /> Address .O. 6itX.. i(S 5 j✓r/f" cl,'';(:(J City/State/Zip <br /> APPLICANT: Owner _Owner's Agent _Contractor _Contractors Agent _Tenant(must provide a letter of consent from the owner to do work in the space) <br /> CONTRACTOR /tit;n t-1 £ Prtp ...TO c, State Lic.# To\t. Pc)83 ct._ City Bus. Lic.# <br /> Address 3aoct c.,)61 Ave ,slJti-e. ( 5 �ti4. 4920 1 Phone/Emaillas- S298-4(07 C <br /> TENANT BUSINESS NAME <br /> CONTACT FOR PERMIT /�� <br /> ((t&C& (-CT L�r.c�i Phone/E-mail ��S gpg4 7° <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK 6 1 OOO <br /> el <br /> Existing Use of Building LO =ee 1Z-Oa.0,Puj HEAT SOURCE: <br /> Proposed Use of Building Gas_ Electric Other <br /> Building type: Single Family _Duplex_Townhouse _Multi-Family, )(Commercial <br /> Type of project: New Addition _Remodel Repair x T.I._Sign Sprinkler Demolition Change of Use <br /> DESCRIPTION OF WORK(additional space provided on the back): <br /> ynt0V EX <tAaje1/d( 60.yi' �( W Wik,a.^ acfCiJD Of=da2,)1 64) e/414. 4./- <br /> 0 <br /> Agob( a MAU pre- bol_ me234iAe -car a. now 1,07(4' (194 116.- . <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 j Lavatory(wash basin) <br /> Water heater j Shower <br /> Gas fireplace ! Kitchen sink&disposal <br /> Gas range j Dishwasher <br /> Clothes dryer j Clothes washer <br /> Range hood Water heater <br /> Exhaust fan j Sink(service/bar/mop/etc.) <br /> Heat pump j Backflow preventer <br /> Unit heater j Urinal <br /> Boiler J Drinking Fountain <br /> Refrigeration j Floor drain • <br /> Woodstove Grease trap <br /> Ducting j Roof drains <br /> Other I Medical Gas <br /> SPRINKLER / SUPPRESSION SYSTEM 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 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. L <br /> S--72-13 <br /> 0 er/ thor' d Agent Signature Date (Revised 3/2013) <br />