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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 /> 29(7 <br /> SITE ADDRESS:-2. <br /> DDRESS:„2.97-1 I-{Orr AVS. PROPERTY TAX# P1 <br /> IT05 <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> OWNER A4"1-.'S Loy'etGi I of S'ocA ow4'SL CoJttlty Phone/E-mail Wz -257- 737b <br /> Address 1507 'All /k• City/State/Zip EUgrcAr r� 1/S07-6,A ' <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 IJ e It C-cmAsE"f'v (bin Gotupawt, L&I Lic. # COE Bus. Lic.# 03O5(O <br /> Address ?,3j D O CAne54-yw4- S4 r VeCe�i\JA %'I Phone/Email 1/Z 11,1( <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT <br /> G�a�1c <br /> Ark C.eivfer C�n>r,s f' c + <br /> Phone/E-mail 112 1-O <br /> 5-Zc° 3( GHrtS�'(Aec cJ DV1)AArL.k4pu\ <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK*BSof Ooa.'JO <br /> Existing Use of Building HEAT SOURCE: <br /> Proposed Use of Building Gas Electric Other <br /> Building type: Single Family _Duplex Townhouse Multi-Family J 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 /> ltnF(Il e01-6< Shell Sppc.e. wL4- new ai-i" Slrou,'o sp4ee <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type of Project: _New_Addn _Alteration_Repair Type of Project: _New_Adds _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 i 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 <br /> Unit heater Urinal <br /> Boiler J Drinking Fountain <br /> Refrigeration Floor drain <br /> Woodstove I 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 /> 2 <br /> //! <br /> Owner/Authorized Agent Signal a ` Date (Revised 3/2013) <br />