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*PERMIT APPLICATIA <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: �pOI 60�1— �' PROPERTY TAX# PERMIT# _D <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> OWNER T-he Jj oeve4 Phone/E-mail 7 Zs' Z.Sc' '116 Z <br /> Address - /fvYr Ave, City/State/Zip /Vere W/¢ g77iot <br /> APPLICANT: Owner _Owner's Agent X Contractor —Contractor's Agent _Tenant(must provide a letter of consent from the owner to do work In the space) <br /> CONTRACTOR (JNII(f�SiT�'ME�f �IcA� Co S State Lic.# (JNIVMC*3y3/Vq City Bus. Lic.#0067216 <br /> Address qb ll- N°� P� ,Muk���eo -`� ZZ�S Phone/Email 204 -36q -9 /a <br /> TENANT <br /> ,,,, A <br /> TCJ <br /> CONTACT FOR PERMIT <br /> 1 I1'�L�err# c1 mic- T�Jwe✓f gull (✓l Phone/E-mail <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK <br /> Existing Use of Building 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_T.I._Sign_Sprinkler_Demolition_Change of Use <br /> DESCRIPTION OF WORK(additional space provided on the back): i"all 2 hand S 0KS tocWe-- QgA,,er <br /> 5,*?p ",\ eke av\d 'i'mi-, k-kxtvrej ^..,1 +v,, <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 I Toilet <br /> Forced air systems I 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 /> I 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 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 s d 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 a or' d the o of thi p pert to or which application is made and I comply with the State Contractors Law 18.27 RCW and 296.200A WAC. <br /> Owne/Authorized Agent Signature Date (Revised 4/2015) <br />