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PE• <br /> RMIT APDL CAT <br /> • • <br /> BUILDING/MECHA lCAL/PLUMB1NG/SIGN/SPRIN1 LErs D MOLT` ION <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# I PE MITI# <br /> SITE ADDRESS:5 E� 2. Z . G—r,�/ / �a0y c/��;c�e9g61iCGG (_ a `(01-�(�_ <br /> LEGAL for new construction: Short Plat/subdivision Lot No, (attach copy of long legal description) <br /> OWNER /44.' 4J/b2h1`/`1C/IX C1`-- f-'e- Phone/E-mail yL5.- S''fS"-305- 4.-€.vciE'ii1 6)11.4,,,,-4,4, 1...,- --t <br /> Address cjG,yZ Z�c-c e--/-c /?e., City/State/Zip Z- -C-.4--e-/7`L-e/4 ?6,'2 G <br /> AP_ : 3. <br /> APPLICANT: owner Owner's Agent Contractor Contractor's Agent Tenant(must provide a letter❑f c❑gsenf from the owner to dp work In the space) A <br /> CONTRACTOR Oe-c, i e A State tic.# City Bus. Lic.# <br /> Address Phone/Email <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT <br /> 0_,/ee/N Cz c,,/Gitr✓ <br /> Phone/E-mail . <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK <br /> Existing Use of Building -CPI? HEAT SOURCE: <br /> Proposed Use of Building 5F—if Gas J Electric Other <br /> Building type: //Single Family Duplex Townhouse _Multi-Family —Commercial <br /> Type of project: _New L.--Addition —Remodel _Repair—T.I. Sign Sprinkler Demolition Change of Use <br /> DESCRIPTION OF WORK(additional spaceprovided on the back): <br /> • <br /> Cisme 6 di-4:1>c'1--7-1�a 1owt44, -,...>4.001-r1- C'/vs r`" co-P-- hi <br /> r MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type of Project: ^New_Addn Alteration Repair Type of Project: New ddn . Alteration_Repair <br /> Show Number(#)of fixturesShow Number(#)of fixtures <br /> NC-air handling units / Toilet <br /> Forced air systems Bathtub <br /> Gas piping ' Z- Lavatory(wash basin). <br /> Water heater J Shower <br /> , J Gas fireplace Kitchen sink&disposal <br /> Gas rangeDishwasher <br /> Clothes dryer Clothes washer <br /> { Range hoodWater heater <br /> - J Exhaust fan Sink (service/bar/mop/etc,) <br /> Heat pumpBackflow preventer(inside bldg) <br /> J Unit heater Urinal . .. <br /> { BoilerDrinking Fountain T <br /> { Refrigeration Floor drain <br /> Woodstove Grease trap , <br /> Ducting Roof drains . <br /> Other Medical Gas <br /> SPRINKLER I 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 /> a,A0_1Sc_ G; .u-.-e I -2-6-i 6 <br /> Owner/Authorized Agent Signature <br /> Date (Revised 4/2015) <br /> • Z <br />