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i ERMIT APPLICATIUII <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:/303 <br /> /rasnDy� /• PR x <br /> 3Q 3! 002^1 300 PERm6# ' I <br /> LEGAL for new construction: Short Plat/subdivision Lot No. JV(attach copy of long legal description) <br /> OWNER cha I`Ket.tlltviamo Phone/E-mail2d(1•8S`1- I 341 4Cebeab140tScoos, <br /> Address 14 tit 4A Pr- U Cv tte. )11,15q,5-City/State/Zip G-uevQ{4 Wltl 9'8203 <br /> APPLICANT:?Owner _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 OWNS ,15 G C. State Lic.# City Bus. Lic.# <br /> Address Phone/Email <br /> CONTACT FOR PERMIT Rttyec in 1(4(.44,444.w", <br /> � �,,pTI/C. <br /> (2.0&)85Yt-(341 <br /> lau /�d '""�(` "I "` T� Phone/E-mail RefpezekLe0 I$Ia.d 0ar ; • •CO <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK /G ' <br /> Existing Use of Building FC/ erli ,', tls ,,/ HEAT SOURCE; <br /> Proposed Use of Building C " 1 b��41/ ota.th( - ,Sty Gas,k Electric Other <br /> Building type: Single Family Duplex Townhouse Multi-Family Y Commercial <br /> Type of project: New Addition Remodel Repair T.I. Sign Sprinkler_Demolitions hange of Use <br /> DESCRIPTION OF WORK(additional space provided on the back): <br /> C ai-i fir-AA wood to M 6 i kmant &At ✓eO4 C#*/L <br /> canes @ ewe simem COrtI tlw6• Remek _ ppytjoi Oil` Vear4dG 10°1h Al <br /> shalo ot ho( h.ar4e .. 4dd per ,� <br /> ( pIriuhd 1are�ilst��p lj p -platvt s <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(inside bldg) <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 /> Owner/Authorizedoed/AJat <br /> Agent Signat A: e 1tie /41.4"-Date �l s (Revised 4/2015) <br /> 102/ <br />