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PERMIT APPLICATIC W <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# E M # <br /> 2//1 4 c-ie/G��74 R, c • 00c-4447-00g- 0o/-00 ) 7 003 <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of Ibng legal descrriiption)J <br /> OWNER RC//c(r'C{! Jfrof4 7`is; LL C Phone/E-mail yzi 33c �1�3 /ajiet,Crr/ ,�)%B/iez7 (et" <br /> Address 7 7/4/ -4,74 Pz A/17f"kit t ys v,//.ff, City/State/Zip ,i71 +y c(!r//, L;f9 c t? i 7t* <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 f r; � Yr/1�i , LLC' State Lic.#7 Lj7FL ypc(,>> City Bus. Lic.#04-9583Address°L'72a f 77 /y,.; the ("/- (/5� ,4 vz25-ZPhone/Email -412e: -6,941 cclirtwe:^keel C <br /> TENANTTUSINEMPNANT CONTACT FOR PERMIT / <br /> �` ' Phone/E-mail 2_‘,4 L1 ZC, <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): <br /> U1.e �i ,14-) 774c v7 <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 ; Shower <br /> Gas fireplace Kitchen sink&disposal <br /> Gas range Dishwasher <br /> Clothes dryer Clothes washer <br /> Range hood Water heater <br /> ( Exhaust fan j 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 amitft9ized 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 /> 7 v <br /> � -e-/ 7/2z//_5- <br /> 0/ '/ <br /> Authorized Agent Signa re Da a (Revised 4/2015) <br />