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• <br /> p513 MITAP* L1C,rA.TIO`�. �{g / <br /> BUILDING/MECHANICAL/PLU RING/SIGN/SPRINKLER/DEMOLITI®N <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 Cedar St., Everett, WA 98201 425-257-8810 FAX 425-257-8857 www.everettwa.org <br /> PROPERTY TAX# pt=RMIT# <br /> SITE ADDRESS: / •II 56 1• <br /> 0q <br /> LEGAL for new construction: Short Plat/subdivision_ Lot No. (attach copy of!Ong legal description) <br /> OWNER 0 tkAc V1 L`n01 .ve[Tyne ijPhone/E-mail , - } .la 0 'CO 1 il(Are'1/1U . <br /> AddressPO'a:,K [2rico. City/State/Zip MIR I Cv e( -I .,u A-- 1 )-------- <br /> • <br /> APPLICANT: X 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 SI ��,'"--utr-ei sane State Lic.# I G N /c( * t I1KECity Bus. Lic.# <br /> ��J ry� I-Ws aL{�k oso -2-1-%-i �" <br /> Address 1211 , Vg�y��U Phone/Email t�IAri ifid-riU( yt+�Yvles,10-• <br /> 1 . 1 :II 1 1 . 1 CONTACT FOR PERMIT ` <br /> SC3h n iV.lA5-ititCh POS) (�.,-.'��-1--D` <br /> Phone/E-mail ,Ju}h f1 (g 4 t610t',l' /A —kt vV e.S, nTlt. <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK r /.7,OcXi , <br /> -7 <br /> Existing Use of Building HEAT SOURCE: <br /> Proposed Use of Building Gay Electric Other <br /> Building type: Single Family vi Duplex__Townhouse _Multi-Family _Commercial <br /> Type of project: _New Addition =Remodel _Repair T.I._Sign Sprinkler Demolition_Change of Use <br /> DESCRIPTION OF WORK(additional space provided on the back): • <br /> CIO ins A -\ s. ‘;L 13(.3.-,_ 'Rock 21ocL kir-kir. j (iJ ...1 <br /> MECHANICAL PERMIT APPLICATION- PLUMBING PERMIT APPLICATION <br /> Type of Project: New_Addn __Alteration_Repair Type of Project: a/New_Addn ^_Alteration__Repair <br /> Show Number(#)of fixtures Show Number(#)of fixtures <br /> NC- 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 I 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 authori zeb by the owner of • roperty to perform the work for—hi, aoolic tion is made and I comply with the State Contractors Law 18.27 RCW and 296.200A WAC. <br /> /.,� `7 0�1 / <br /> Owner/ uthorized A en Si nature Date (Revised 4/2015) <br /> l2 <br />